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 Cancer

January 2011
What’s New in Cancer Treatment
Dr P. P. Bapsy
 
Cancer, in the past, was often regarded as a death sentence. This belief stemmed from a variety of causes such as poor understanding of the causes of cancer, lack of dedicated specialist healthcare professionals, and primitive surgical, medical and radiotherapy techniques.

New, Improved
Development in cancer therapeutics has not been limited to newer diagnostic and preventive modalities. It has also been applied to the field of preventive oncology.  Thus, past screening modalities limited to film-based mammography, PSA screening, PAP smear, decal occult blood test have now been replaced by
  • Digital mammography: A technique that uses a computer, rather than X-ray film, to record X-ray images of the breast.
  • Proteonomics: Large-scale study of proteins, particularly their structures and functions.
  • Virtual colonoscopy: A method of examining the colon by taking a series of X-rays (called a CT scan) and using a high-powered computer to reconstruct 2-D and 3-D pictures of the interior surfaces of the colon from these X-rays.
  • Molecular tool DNA microarray: A collection of microscopic DNA spots attached to a solid surface forming an array, to measure the expression levels of large numbers of genes simultaneously.
Old Theories
Early cancer therapy centred on surgical excision as the primary treatment modality for solid tumours. It was theorised that cancer spread occurred sequentially from the primary site to the regional lymph nodes and then on to distant sites. Therefore, it was hypothesised that complete local excision of all cancerous cells would lead to effective disease control. In patients with untreated cancer, median survival was frequently measured in months, leading the surgeons to perform more and more radical surgeries. The development of the new adjuvant therapy protocols has made possible more of organ conservation surgeries.

Specific Targets
Traditional chemotherapy (that was toxic to the body cells) generally affects both rapidly dividing normal and malignant cells. Recent advances in cancer biology have led to the identification of numerous specific molecular targets for drug therapy. These molecular targets often play a key role in the signal transduction pathways that regulate tumour cell growth, proliferation, migration, angiogenesis (growth of new blood vessels from already existing ones), and apoptosis (programmed cell death). The use of targeted or rational therapy has furthered the success of oncology, allowing therapeutic modification of the biologic activity of a specific “targeted” protein with abnormal function in malignant cells.

Also, with the development of newer drug delivery systems like nano particle drug delivery and liposomal drugs (drugs encapsulated in a lipid bilayer to alter certain properties), the optimal dose of drugs can now be delivered without any increase in toxicity.

Better Chances
Cancer clinical trials have made changes in the treatment strategies and in creating evidence based treatment using multi disciplinary therapy in most cases. Combining chemotherapy, radiation therapy and surgery effectively - and in the right sequence - has improved the survival chances and quality of life in most patients. There have been better technology.

In the new decade especially, the major thrust of oncology will be on prevention, changing lifestyle, improved surveillance techniques, development of preventive agents and gene therapy. Targeted therapeutic modalities will enable the oncologist to tailor treatment to specific tumour type.  “One size doesn’t fit all” is certainly the slogan for the future treatment modalities of cancer.

Novalis TX Radio Surgery
Novalis TX radiosurgery uses a treatment beam contoured to the exact shape of your tumour, pre-cisely delivering treatment while protecting surrounding healthy tissue. And a treatment session lasts just minutes, not hours. It is:

Precise:
  • Shapes the radiation beam to match the exact contour of the tumour or lesion, ensuring the maximum prescribed dose of high-energy radiation is delivered to the entire tumour.
  • Protects surrounding healthy tissue.
  • Adapts the treatment beam to breathing and other body movements to continuously maintain safe, complete and accurate dose delivery.
Fast:
  • Non-invasive, outpatient procedure lasts just 15 to 20 minutes, rather than hours.
  • Reduces the likelihood of patient or tumour movements, ensuring the highest possible level of treatment accuracy.
Versatile:
  • Employs a wide range of treatment modalities, ensuring you receive the best treatment for your individual case. Other radiosurgery devices are limited to only one treatment modality
  • Delivers the industry’s highest dose rate, penetrating deeper to treat tumours previously considered untreatable.
  • Offers hope to patients with clinical conditions once considered untreatable and those for whom surgery is not an option
Dr. P. P. Bapsy is Senior Consultant – Medical Oncology at Apollo Hospitals, Bangalore


    
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