Management of cancer : Radiotherapy and Chemotherapy

Management of cancer

The treatment or management of cancer depends on an accurate di-agnosis. Diagnosis is made through microscopic observations(tissue biopsy), study of markers on the surface of cells, cytochemical methods, cytogenetics and various scanning and 'x' ray diagnostic methods.

In order to compare results and for communicating treatment programme among medical personnel staging systems are essential (Ex: stage1, stage2) staging defines tumours as either confined to the tissue of origin or having spread to local tissues and organs and finally as having metastasized.

After diagnosis, treatment of cancer involves surgery, chemotherapy, radiotherapy and hormonal treatments.

Till last century, surgery was the only effective method of treatment. Even to-day through surgery biopsy can be effected for diagnosis. If the tu-mour is restricted to the primary site, through surgery it can be removed. In latest treatment procedures surgery is restricted to affected region, rather than amputation or removal of the entire organ.

Radiotherapy :- Discovery of x-rays by Roentgen(1895) and of radioactivity by Curies in 1899 opened new ways of treating cancer. In Radiotherapy high energy ionising radiations are used. The radiations used are x-rays and gamma rays or subatomic particles such as beta particles, high energy electrons and neutrons or charged particles like helium ions. Ionising radiations can penetrate tissues. They can damage DNA leading to cell death and mutagenesis. The basis of radiation therapy depends on the differential sensitivity of the tumour tissue and the normal tissue. Hence the aim of radiotherapy is to prescribe sufficient radiation dose to the tumour, sparing as much of the normal tissue as possible.

Chemotherapy :- The purpose of chemotherapy is to prevent cancer cells from multiplying, invading and metastasizing. The chemicals used in treatment affect cell multiplication and tumour growth. Several drugs are now available for usage. They can used singly or in combination. Some cancers like breast cancer are hormone dependent. Hence hormones are used in their management.

Inspite of all advances in diagnostics and treatment, the death rate due to cancer is greater. Primary prevention of cancer will be a better alternative to diagnosis and treatment. 70% to 80% of cancers result from environmental causes. Hence public awareness towards environmental issues is a need. 33% of cancers in India are tobacco related. Hence smoking cessation and other measures to reduce tobacco usage are to be insisted upon. Consumption of fibrous food and avoidance of fatty food will avoid tumours related to alimentary canal.

Thus it is apparent that fight against cancer will be successful with early detection and appropriate education for avoidance.