Picture 21. The success of surgery relies on a lot of people and a clean theatre.
Cancer can start anywhere in the
body and there is a danger that, if not treated early enough,
it can spread to form secondary tumours.
Doctors need to be able to tackle the primary tumour as well
as any secondary tumours and so a range of medicines and treatments
may be used together.
Surgery
Often the first treatment is to surgically remove the malignant tumour to stop it growing and spreading further. This is most effective against tumours that are in a defined area. For example, it is particularly effective against breast, ovary and testicular cancers. Patients may be given radiotherapy or chemotherapy before the surgery to try and reduce the size of the tumour before it is operated on.
Picture 22. Some tumours need a blood supply to keep growing. Medicines can prevent the development of this blood supply.
Chemotherapy
Medicines have been developed that can treat both primary and secondary tumours. They work by targeting rapidly growing cells to disrupt the process of mitosis. Some prevent the new cells splitting apart whilst others disrupt the production of new DNA.
Different types of chemotherapy may be used to try and prevent the tumour from developing a blood supply or in cases were the tumour is stimulated to grow by the body's own hormones.
New treatments are also being developed which will vaccinate the body against cancer cells. They will stimulate the body's own immune system to destroy cancer cells that have unique molecular 'flags' on their surface that identify them as cancer cells.
Radiotherapy
High energy gamma radiation is aimed at the growing tumour. This damages the DNA in rapidly dividing cells and so helps to destroy the tumour. More information about radiation and radiotherapy is given in the next section.
How different cancers are treated
Roll your cursor over each of the cancers to find out more.
Side effects
Cancer treatments generally target cells that are growing and dividing rapidly. This kills the tumour cells but it can also have some nasty side-effects on healthy cells in the body. Hair loss is common as the growing hair cells are affected and sterility is a problem in both men and women. Many patients feel sick and have aches and pains during chemotherapy.
Clearly these side effects are very unpleasant but the medicines are tackling a disease that would kill the patient if it was left untreated. Many people recover from cancer and feel that even the most horrible side effects were worthwhile.
Most patients diagnosed with bowel cancer will have the affected part of their colon surgically removed.
Radiotherapy may be used before the surgery to reduce the size of the tumour or after the therapy to try and kill any cancer cells that remain.
Unfortunately, bowel cancers are often difficult to treat because they are often not detected at an early stage in their development. This gives them a chance to spread to other parts of the body as secondary tumours.
Chemotherapy may be given although its success is limited. New approaches to treating bowel cancer include using antibodies that destroy the tumour and genetically modified viruses that kill cancer cells but do not infect normal cells.
Skin cancer
The most serious form of skin cancer is called malignant melanoma. It looks like a growing and irregular mole on the skin. They tend to be visible and so are usually diagnosed quite early in their development.
The main treatment is to surgically remove the mole and a portion of healthy skin around the melanoma. This usually removes all of the cancer cells and has a high success rate.
If a melanoma is ignored, it can spread to other parts of the body. This is much more serious and following removal of the original tumour, chemotherapy and radiotherapy may be used to treat any secondary tumours.
Breast cancer
Surgery can be used to remove the primary tumour. If it appears that the tumour has not spread, this may be the only treatment or radiotherapy of the surrounding tissue may be used to kill any cancer cells remaining in the area.
Chemotherapy can also be used before and after surgery to reduce the size of the primary tumour and to kill any cancer cells that may have spread.
Hormone therapy is given with types of breast cancer that are stimulated to grow by the body's own oestrogen. Tamoxifen is a medicine that blocks the effects of oestrogen and so reduces the chance of the breast cancer returning.
In cases where the breast cancer has spread, women may be given chemotherapy that includes a medicine containing antibodies that can target specific types of cancer cells. Vaccines are also being developed to help stimulate the body's own immune system to destroy the cancer cells.
Lung cancer
There are two main types of lung cancer. Small cell lung cancer is treated with chemotherapy. Surgery is not used because it is unlikely to remove all the cancer cells. Pharmaceutical companies and other research laboratories are actively looking for and testing new treatments of this type of cancer.
Non-small cell lung cancer is the more common form of lung cancer. It can be treated by surgery, which in serious circumstances could include the complete removal of a lung. Chemotherapy and radiotherapy are often used to treat the original tumour and also to kill any cancer cells that have spread through the body.
Ovarian cancer
With most cancers of the ovaries, the first procedure will be major surgery to remove the ovaries, fallopian tubes and womb.
During the operation, the surgeon will also look to see if the tumour has spread to other parts of the abdomen. They will remove any secondary tumours which helps to make the chemotherapy that follows the operation more successful.
Radiotherapy is rarely used in the treatment of ovarian cancer. However, a radioactive antibody against the cancer cells is being developed. This will target tiny amounts of radiation directly onto the cancer cells.
Prostate cancer
Some prostate cancers grow very slowly and, if this is the case, may just be monitored with blood tests and scans and have no further treatment.
If they are diagnosed early, quickly-growing prostate cancers are first treated with radiotherapy to kill the tumourcells. This may also be combined with hormone treatment. Some prostate cancers are stimulated to grow by the male sex hormones and medicines can be given to block their effects.
Surgery may also be used to remove the all or part of the prostate gland.
