Treatment

Cancer Treatment includes therapies like Angiogenesis Inhibitors, Chemotherapy, Gene Therapy, Hyperthermic intraperitoneal Therapy, Immunotherapy.

Angiogenesis Inhibitors
Angiogenesis is a process by which new blood vessels are formed. Some cancerous tumors are very efficient at creating new blood vessels, which increases blood supply to the tumor and allows it to grow. Cancer cells initiate angiogenesis by sending signals to nearby tissue and activating proteins that foster blood vessel growth. As researchers gained a better understanding of this process, they have developed several drugs that inhibit angiogenesis and short-circuit cancer development. Blood vessels feed tumors the nutrients and oxygen they require to thrive and spread, so researchers also are investigating whether a tumor’s established blood vessel network can be made to fight the cancer. A number of angiogenesis inhibitors have been approved by the Food and Drug Administration and are currently being used to treat cancer : ♦ Bevacizumab (Avastin®): brain tumors and cancers of the breast, colon, kidney,lung and rectum ♦ Everolimus (Afinitor®): kidney cancer and neuroendocrine tumors ♦ Pazopanib (Votrient®): kidney cancer ♦ Sorafenib (Nexavar®): liver cancer and kidney cancer ♦ Sunitinib (Sutent®): kidney cancer and neuroendocrine tumors
Chemotherapy
MD Anderson offers dozens of chemotherapy drugs to treat a wide variety of cancers, both as standard treatment and through clinical trials of new, innovative therapies. Researchers are continually working to tailor chemotherapy drugs to attack specific tumors, which provides a highly effective treatment with fewer side effects and less impact on healthy organs and tissues. Here are the types of chemotherapy procedures available at MD Anderson : ♦ Angiogenesis inhibitors ♦ Hyperthermic intraperitoneal chemotherapy (HIPEC) ♦ Gene therapy ♦ Immunotherapy Oral Cancer Specialist Doctor in Hyderabad What is Chemotherapy ? Chemotherapy uses powerful drugs to kill cancer cells, control their growth, or relieve pain symptoms. Chemotherapy may involve one drug, or a combination of two or more drugs, depending on the type of cancer and its rate of progression. Chemotherapy can be used in combination with other treatments such as surgeryor radiation, to make sure all cancer cells have been eliminated. Chemotherapy is administered in three ways : ♦ Intravenous (IV) is by far the most common method. A needle is inserted into a vein and attached with tubing to a plastic bag holding the chemotherapy drugs. The needle is taken out at the end of each treatment. For some patients who undergo several chemotherapy sessions, a catheter, another type of plastic tubing, is inserted into one of the large veins and left in place during the entire chemotherapy regimen. Some patients have a metal or plastic disc known as a “port” implanted under the skin, to serve as an IV connection device. ♦ IV bags are attached to a tall metal stand with wheels, providing some mobility. Some patients wear a small pump outside the body, with minimal interference to their normal routine. Other patients may have a drug pump surgically inserted into their body. ♦ Oral chemotherapy drugs are taken by mouth, either in pill or liquid form. ♦ Injections are administered into the muscle, under the skin, or directly into a cancer lesion, depending on the type or location of the cancer. Side Effects Side effects vary from patient to patient and with the type of chemotherapy drugs used. The good news is that there are therapies to help you cope with some side effects, and lost hair does grow back, although sometimes in a different color or texture. The most common side effects of chemotherapy include : ♦ Temporary hair loss ♦ Fatigue ♦ Nausea ♦ Pain ♦ Increased risk of infection ♦ Depression ♦ Increased sun sensitivity ♦ Numbness or weakness in the hands and feet
Gene Therapy
Much of today’s cancer research is devoted to finding missing or defective genes that cause cancer or increase an individual’s risk for certain types of cancer. Gene research at MD Anderson has resulted in many important discoveries. We identified the mutated multiple advanced cancers gene (MMAC1) involved in some common cancers. We also performed the first successful correction of a defective tumor suppressor gene (p53) in human lung cancer. Current gene therapies are experimental, and many are still tested only on animals. There are some clinical trials involving a very small number of human subjects. The potential benefits of gene therapy are two-fold : ♦ Gene-based treatments can attack existing cancer at the molecular level, eliminating the need for drugs, radiation or surgery ♦ Identifying cancer susceptibility genes in individuals or families can have a major role in preventing the disease before it occurs The focus of most gene therapy research is the replacement of a missing or defective gene with a functional, healthy copy, which is delivered to target cells with a “vector.” Viruses are commonly used as vectors because of their ability to penetrate a cell’s DNA. These vector viruses are inactivated so they cannot reproduce and cause disease. Gene transfer therapy can be done outside the body (ex vivo) by extracting bone marrow or blood from the patient and growing the cells in a laboratory. The corrected copy of the gene is introduced and allowed to penetrate the cells’ DNA before being injected back into the body. Gene transfers can also be done directly inside the patient’s body (in vivo). Other therapies include : ♦ Injecting cancer cells with special genes that make the tumor more receptive to the effects of anti-cancer drugs ♦ Introducing the multi-drug resistant (MDR) gene into bone marrow to make stem cells more immune to the toxic side effects of anticancer drugs. Stem cells are responsible for the production of blood cells. Gene therapy is a complicated area of research, and many questions remain unanswered. Some cancers are caused by more than one gene, and some vectors, if used incorrectly, can actually cause cancer or other diseases. Replacing faulty genes with working copies also brings up ethical issues that must be addressed before these therapies can be accepted for preventing cancer. Talk to your cancer specialist about the implications of gene therapy.
Hyperthermic Intraperitoneal Therapy
Hyperthermic intraperitoneal chemotherapy (HIPEC) is a cancer treatment that involves filling the abdominal cavity with chemotherapy drugs that have been heated. Also known as “heated chemotherapy,” HIPEC is performed after the surgeon removes tumors or lesions from the abdominal area. After all visible tumors are removed, cisplatin, a chemotherapy drug, is heated to 103 degrees Fahrenheit (42 degrees Celsius) and pumped through the abdominal cavity. The patient lies on a special cooling blanket to keep their body temperature at safe levels during the procedure. Surgeons physically rock the patient back and forth on the operating table for about 1½ -2 hours to ensure that the drug reaches all areas of the abdomen, killing any cancer cells that remain after surgery and reducing the risk for cancer recurrence. The heat makes the drug more effective in killing cancer cells, and it also increases blood flow to the area. Benefits of HIPEC Hyperthermic intraperitoneal chemotherapy has several benefits as compared to standard chemotherapy : ♦ HIPEC is a single treatment done in the operating room, while standard chemotherapy requires multiple treatments ♦ 90% of the chemotherapy drug stays within the abdominal cavity, making it less toxic for the patient ♦ It allows for a more intense dose of chemotherapy Heated chemotherapy is used on both adult and pediatric patients to treat soft tissue sarcomas, appendix cancer, Wilms’ tumor and other cancers in the abdominal cavity. MD Anderson was the first cancer center in the United States to use HIPEC on children with desmoplastic small round cell tumor (DSRCT), an extremely rare form of soft tissue sarcoma that causes hundreds of lesions in the abdomen. This therapy has doubled the survival rate of children with DSRCT as compared to standard chemotherapy treatment. Side Effects Hyperthermic intraperitoneal chemotherapy does have some side effects. Patients must be prepared to receive nutrition through a feeding tube or IV for about two weeks, while the digestive system recovers from the intense dose of chemotherapy.  
Immunotherapy

There are treatments that use the body’s own natural defenses to fight cancer. Immunotherapy, also known as biotherapy or biological response modifiers, works on white blood cells – the body’s first line of defense against disease. White blood cells can be stimulated in various ways to boost the body’s immune response to cancer, with little or no effect on healthy tissue. Immunotherapy can also be used to lessen the side effects of other cancer treatments.

Some immunotherapies have received approval from the Food and Drug Administration for certain types of cancer. Others are being tested in clinical trials. Biological response modifiers are developed in a laboratory and then injected into the body.

Side effects of immunotherapies can vary, but most exhibit similar symptoms, including fatigue, a rash or swelling at the injection site, and flu-like symptoms including nausea, diarrhea and fever.

There are five general types of biological response modifiers. They can be used alone or in combination with each other, or they can be used in addition to other cancer treatments.

♦ Interferons are a group of three proteins released by white blood cells in reaction to invading organisms, to improve the immune system’s reaction to cancer. Interferon alpha is approved for treatment of some cancers, including melanoma and chronic myeloid leukemia, but is being studied for use on other cancers.
♦ Interleukins are proteins that increase growth and activity in the body’s immune cells. Ten interleukins have been identified so far, but IL-2 is approved as an anti-cancer treatment, particularly for kidney cancers and melanomas that have metastasized (spread) to other regions of the body.
♦ Monoclonal antibodies are created in the laboratory by fusing two different types of cells together. Monoclonal antibodies are designed to attack specific areas on the surface of cells known as antigens. Antigens help the body identify cells that are foreign, like germs or cancer cells, and stimulate an immune response. Monoclonal antibodies show promise both as a cancer treatment and a diagnostic tool.
♦ Vaccines help the body recognize cancer cells and trigger the immune system to destroy them. There are several types of cancer vaccines. Some contain cancer cells that have been killed with radiation so they cannot produce new tumors. Others contain lab-produced antigens designed to attach themselves to cancer cells. Cancer vaccines are used to either help the body reject cancer tumors or to keep them from recurring.
♦ Colony Stimulating Factors (CSF) work in the bone marrow, where red and white blood cells and platelets are produced. Colony Stimulating Factors increase the division of bone marrow cells, which strengthens the immune system and allows patients to endure higher doses of chemotherapy drugs.

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