Treatment for cancer

How is cancer treated?

The group of healthcare professionals who work together to find, treat and care for people with cancer is called the "cancer care team." The cancer care team may include any or all of the following healthcare providers, in addition to others:

• Primary care physicians.
• Pediatricians.
• Pathologists.
• Hematologists.
• Oncology specialists (medical oncologist, radiation oncologist, surgical oncologist).
• Surgeons (including surgical specialists such as urologists, gynecologists and neurosurgeons).
• Nurses.
• Oncology nurse specialists.
• Oncology social workers.
• Pharmacists.
• Pastoral care.
• Respiratory therapists.
• Physical therapists.
• Lab technicians.
• Child life therapists.
• Psychologists.
• Radiation technicians.
• Dietitians.

Specific treatment for cancer will be determined by your child's physician based on:

• Your child's age, overall health and medical history.
• Type of cancer.
• Extent of disease.
• Development of new treatment options.
• Your child's tolerance for specific medications, procedures or therapies.
• Expectations for the course of the disease.
• Your opinion or preference.

Treatment for certain types of cancer may include:

• Antibiotics (to prevent and treat infections)
• Supportive care (to treat the side effects of treatment, such as nausea, diarrhea, anemia and mouth sores)
• Surgery (for organ or tumor removal)
• Placement of a central line - A central line is a catheter placed in a large vein that supplies the circulatory system. A central line is needed for insertion of medications and blood products and to provide a site where blood samples can be easily taken without pain to the child. There are several different types of central lines that are used in the treatment of cancer. Your child's physician will explain the benefits of the available central lines.
• Continual follow-up care to determine response to treatment, detect recurrence of disease and manage the effects of treatment.
• Biological response modifiers and immunotherapy - Colony-stimulating factors, interleukins, monoclonal antibodies, tumor necrosis factor, interferons, cytokines and the development of other biological response modifiers are the latest advances in the fight against cancer. Many of these modifiers are normally found in the body and assist with the immune system's ability to protect the body against invasion.

In addition, physicians are using the body's own processes to fight disease. In the near future, there may be a development that can make our bodies recognize cancer cells and destroy them or simply filter them out like common viruses.

The two most common forms of treatment for cancer include chemotherapy and radiation therapy.

What is chemotherapy?

Chemotherapy is a medication that can help fight cancer.

How does chemotherapy work?

In most cases, chemotherapy works by interfering with the cancer cell's ability to grow or reproduce. Different groups of drugs work in different ways to fight cancer cells. Often a combination of chemotherapy drugs is used to fight a specific cancer.

How is chemotherapy administered?

Chemotherapy can be given:

• As a pill to swallow.
• As an injection into the muscle or fat tissue.
• Intravenously (directly to the bloodstream).
• Intra-thecally with a lumbar puncture (to treat cancer cells in the cerebral spinal fluid).

What are the side effects of chemotherapy?

Chemotherapy interferes with fast-growing cancer cells, but it also affects some healthy cells. Before receiving chemotherapy for treatment of cancer, many tests are performed to evaluate the baseline (pre-treatment) function of heart, kidneys, lungs, eyes, ears and reproductive organs. Some chemotherapy may affect the function of these organs either during treatment or months to years after treatment. Some treatment may affect fertility. Other potential side effects may include, but are not limited to, the following:

• Bone marrow suppression - Red blood cells that carry oxygen, white blood cells that fight infection, and platelets that help the blood to clot are usually lowered with chemotherapy use. Risk for anemia, fatigue, infection and bleeding are increased with bone marrow suppression.
• Mouth sores, nausea, vomiting, and diarrhea - Chemotherapy affects the fast-growing cells of the mouth and gastrointestinal (GI) tract.
• Hair loss, also called "alopecia" - Chemotherapy affects the cells of the hair and nails. After treatment is completed, most children's hair will grow back. Texture of hair and fingernails may change.

What is radiation therapy?

Radiation therapy is the use of special kinds of energy waves or particles to fight cancer.

How does radiation therapy work?

Certain levels of radiation can kill cells, destroy cell lining, or prevent cells from growing and reproducing. Radiation therapy mostly affects the fast growing-cells associated with cancer. It can, however, affect healthy cells as well.

How is radiation therapy given?

Radiation therapy can be given either externally (outside the body), or internally (inside the body):

• External radiation - radiation is given by a large machine that points the energy waves directly at the site of the tumor or over the entire body to destroy cancer cells. Radiation therapy is not painful.
• Internal radiation - uses a substance or material that has radioactive properties. Depending on the type of internal radiation, it may be given by: swallowing, injection or implanted directly into the tumor or body cavity.

What are the side effects of radiation therapy?

The side effects of radiation depend on the dose and location and if it is internal or external. Before receiving radiation for treatment of cancer, many tests may be performed to evaluate the baseline (pre-treatment) function of heart, kidneys, lungs, eyes, ears and reproductive organs. Some radiation may affect the function of these organs either during treatment or months to years after treatment. Some treatment may affect fertility. The side effects usually relate to the area of the body that is receiving the radiation treatments. Potential side effects may include, but are not limited to, the following:

• Hair loss, also called "alopecia" - Hair loss may occur if radiation therapy of the head is given. After treatment is completed most children's hair will grow back.
• Bone growth - Bone growth may also be affected, especially with young children that are still having significant bone growth. Height stature and/or limbs may be shortened because of the effect of radiation.
• Skin changes - The skin may be more sensitive, reddened, or irritated after having radiation. Skin care is an important part of radiation treatment. Skin changes are short-term effects of radiation. Your child's physician will explain the necessary prevention and treatment of any skin problems related to radiation.
• Diarrhea, nausea, and vomiting - If radiation therapy of the pelvis or abdomen is given, a child may experience diarrhea, nausea and vomiting.