We decide about the treatment on the basis of the stage of presentation and the biopsy report. We explain everything to the patient and a combined decision is taken by the patient and the doctor.
Surgery and radiotherapy both have power to cure cancer, but they have their own limitations or complications. Where the surgical approach is easy and in the experienced hands, surgery is better than radiotherapy. But if the approach is difficult and the chances of surgical complications are more radiotherapy is better e.g. deep seated brain tumors.
The choice of treatment depends on many factors like biopsy report, extent of tumor, stage of presentation, patient’s nutritional status, patient’s financial status and patient’s choice.
There are a lot of chemotherapy drugs available presently. Few of them are natural products we extract them from trees or other sources, few of them are synthetic products. There is a new variety of agent called the ‘targeted therapy’. These agents are used to inhibit the growth of cancer cells by inhibiting a particular molecule in the cell cycle.
Apart from these there are some hormonal agents that can be used as systemic therapy against few cancers like breast cancer or prostate cancer.
The decision about the chemotherapeutic drugs is taken on the basis of type of the tumor, patient’s condition and cost effectiveness. There are tumors which respond to a particular drug but they may not respond to other drugs.
Chemotherapy brings a lot of side effects which can be divided into systemic effects and local effects. Chemotherapy can destroy the veins in the hands or there can be necrosis of the skin if chemotherapy extravasates. To prevent such complications chemotherapy port are used. These are small chambers put under the skin and the chamber is connected to the superior venacava via silicon catheters. When the drug is given into the chamber, it goes directly to the superior vena cava. Thus both the hands are spared.
Ideally chemotherapy ports should be used in all the patient, but we should discuss all related issues with patient including cost and if he or she agrees then we should use the chemotherapy ports.
It’s not always true. The new drugs which are coming up are very costly but the older drugs are not so. In government hospitals you can have chemotherapy drugs just free of cost and at many places like trust hospitals, cost of drug is much less than the MRP.
This is a very difficult question to answer. When tumor has spread all over the body, only option is chemotherapy. If first line becomes ineffective we should switch over to the second line chemotherapy. Similarly if tumor doesn’t respond to second line, we have to go for the third line and so on. Now few people say that we should stop after second or third line, but others are in favor of giving more therapies. So the decision depends on the type of cancer, patient’s condition, experience of oncologist and patient’s choice
As I told you that cancer treatment has got 3 aspects first is surgery, second is radiotherapy. In all pathies other than allopathy, drugs are given by oral route or by per-rectal route. So they try to treat cancer with the help of those medicines, that means it is a form of chemotherapy. When we are using alternative medicines it should be compared with chemotherapy not with the allopathy as a whole. As compared to surgery or radiotherapy, chemotherapy has got least chance of cure.
So the alternative medicine should be used in place of chemotherapy not in place of surgery or radiotherapy.
When the patient is in stage 4 of disease and we know that we cannot cure the patient then we start palliative (symptomatic) treatment. Here our aim is to decrease the pain of patient, or in other words to decrease the sufferings of the patient, instead of increasing the lifespan.
The cancer can be prevented by avoiding the agents that can cause cancer called the carcinogenic agents e.g. tobacco, alcohol, direct expose to sunlight, insecticide pesticides, carcinogenic viruses and pollutants.
Healthy lifestyle is also important in cancer prevention. Improved immunity helps to fight against cancer.
Detection of early cancer is called ‘screening’. Presently we don’t have a single test to detect any cancer in body. The screening tests are directed towards the most common cancers e.g. among females to detect early breast cancer we advise bilateral mammography after the age of 40 years. For the detection of prostate cancer we advise a blood test called PSA in males.