General Treatment Options for Cancer Patients
The general treatment options for cancer patients include surgery, radiation therapy, chemotherapy, targeted therapy, immunotherapy, and hormonal therapy, with the specific approach determined by cancer type, stage, and patient factors. 1, 2, 3
Surgery
- Surgery remains the primary treatment option for medically fit patients with resectable cancer, particularly in early stages 1
- For specific cancers like gastric cancer, subtotal gastrectomy is preferred for distal cancers, while proximal or total gastrectomy is recommended for proximal tumors 1
- Surgical approaches should be tailored to the specific cancer type and location, with consideration of organ preservation when possible 1
Radiation Therapy
- Approximately 50% of all cancer patients receive radiation therapy during their course of illness, contributing to about 40% of curative cancer treatments 2
- External-beam radiotherapy should be of optimal quality and deliver appropriate doses based on cancer type and stage 1
- For locally advanced non-small-cell lung cancers, a minimum dose of 60 Gy with classical fractionation is recommended 1
- Radiation may be used as primary treatment, adjuvant therapy after surgery, or for palliation of symptoms 1
- Radiation therapy techniques include conventional fractionation, hypofractionated, and split-course approaches depending on patient factors and tumor characteristics 1
Chemotherapy
- Chemotherapy remains a cornerstone of treatment for many cancer types, including lung, breast, and colorectal cancers 1
- Maintaining chemotherapy dose intensity is crucial for greater survival in the curative setting and for optimal treatment outcomes in the non-curative setting 1
- Specific regimens are determined by cancer type, stage, and patient characteristics 1
- Common side effects include myelosuppression (neutropenia, anemia, thrombocytopenia), which may require dose adjustments 1
Targeted Therapy
- Targeted therapies are designed to attack specific molecular targets in cancer cells 1, 4
- Examples include:
- These therapies are often selected based on specific biomarkers or genetic mutations in the tumor 4
Multimodality Approaches
- Many cancers benefit from combined treatment approaches 1
- For breast cancer, treatment may include surgery followed by radiation therapy and/or systemic therapy 1
- For non-small cell lung cancer, treatment may include combinations of surgery, radiation, and chemotherapy depending on stage 1
- Perioperative chemotherapy is recommended for medically fit patients with resectable locoregional distal esophageal, gastroesophageal junction, and gastric adenocarcinoma 1
Clinical Trials
- Patients should be given the opportunity to participate in clinical trials that may improve their outcomes or the care of future patients 1
- Only about 3% of adult cancer patients currently participate in clinical trials, representing a significant missed opportunity 1
- Clinical trials offer access to promising new interventions when standard therapy has limited efficacy 1
Palliative and Supportive Care
- Best supportive care is an integral part of treatment, especially for patients with metastatic and advanced cancer 1
- When disease-directed options are exhausted, patients should transition to symptom-directed palliative care to minimize physical and emotional suffering 1
- Palliative interventions may include endoscopic placement of self-expanding metal stents, laser surgery, or radiation therapy for symptom management 1
Treatment Selection Considerations
- Treatment decisions should be based on cancer type, stage, molecular characteristics, patient performance status, and comorbidities 1
- Discussions about anticancer interventions should include information on likelihood of response, nature of response, adverse effects, and risks 1
- Multidisciplinary team management is essential for optimal treatment planning 1
- Patients with good performance status can receive active treatment, while those with poor performance status may benefit most from supportive care 1