There are some promising new therapeutic approaches in the research pipeline. With some of them the first successes have already been achieved. However, the three “classic” therapies are still the most frequently recommended way of treating cancer: surgery, radiation and chemotherapy. And with good reason, because these forms of therapy have proven themselves millions of times and have been extensively researched.
However, the success of the treatment is offset by risks and side effects. Which therapy or therapy combination works best without overburdening the patient depends on the type of tumor and the individual course of the disease. Our overview briefly introduces the three most common forms of therapy and names their advantages and disadvantages (we will deal with newer relevant approaches.
surgery
The spectrum of possible surgical interventions in cancer medicine is wide. It ranges from the removal of tissue samples (biopsy) and the removal of suspicious, superficial skin changes to minimally invasive surgical techniques (so-called “keyhole surgery”), in which surgical instruments are worked through a small incision (such as endoscopy or the Laparoscopy), up to the conventional, so-called open operations. With these, parts of an organ or the entire affected organ as well as neighboring tissues that are affected by the tumor – if the cancer has spread – can be removed.
The prerequisite for a successful operation is that there is a local cancer disease. This is often the case, especially in the early stages. As the disease progresses, the cancer continues to spread in the body. The probability that one or more operations alone lead to a cure then decreases accordingly. For example, operations in cancer medicine are often accompanied by further therapeutic measures with the aim of combating remaining cancer cells.
Depending on the type and extent of the tumor, an operation opens up good chances of recovery. These are offset by the risks that are always associated with operations. They concern a possibly necessary general anesthetic, the fundamental risk of infection or also possible problems with wound healing. In addition, there are possible risks from the removal of tissue and organs or parts of organs. After all, the risks and burdens for patients have been reduced overall in recent years through the increased use of minimally invasive procedures.
radiotherapy
Like an operation, radiation therapy (technical term: radiotherapy) also offers the possibility of targeting or removing individual tumors. For this purpose, these are penetrated with ionizing radiation. “Ionizing” means that the rays at the molecular level from neutral atoms and molecules generate positively and negatively charged particles that trigger biological and biochemical reactions in the cells. As a result, the desired damage occurs in the tumor cells. Radiation for healing purposes goes back to the 19th century. Today’s technologies are correspondingly advanced in this field.
The proven form of therapy is now used in around every second cancer patient, whether as a sole treatment or as an adjunct therapy. In addition to ionizing radiation, radioactive rays are also used in some cases (nuclear medicine). However, the rays cannot be as targeted as a surgeon. In the case of radiation, therefore, healthy tissue is practically always affected. However, in contrast to tumor cells, this has the ability to regenerate. The decisive factor is the radiation dose, which is supposed to be fatal for the tumor cells and at the same time has to protect the healthy cells sufficiently.
As an alternative to external radiation through the skin, there is also the option of placing tiny radiation sources directly on the tumor. They then radiate particularly strongly only a few millimeters. With both forms of radiation, the possible side effects are usually limited to the irradiated region and usually only occur temporarily. For example, radiation in the abdominal area can lead to diarrhea, vomiting or nausea, and hair loss if the head is exposed to high doses of radiation.
Despite its long history of cancer app, radiation therapy is far from reaching the end of its development. In the last few years in particular, significant advances have been made to increase effectiveness and minimize side effects.
chemotherapy
Chemotherapy, which has been used in its current form for around six decades, is, in contrast to surgery and radiation therapy, usually a systemic treatment. This means that the entire organism and not just individual parts of the body can be reached. This is ensured by absorption into the blood, which takes place via tablets, injections or infusions. The chemical substances that are administered by default are called cytostatics. They prevent the cell division mechanism of cancer cells. These then die off.
Since chemotherapy affects the entire body – often with the exception of the brain – it is particularly suitable in advanced cancer stages when daughter tumors (metastases) have already spread throughout the body. However, its systemic effect is also the greatest disadvantage of chemotherapy: it also attacks healthy cells. However, these are better equipped than cancer cells, as they usually do not divide as often.
Possible side effects that can occur within hours or days after the start of treatment, but also months or years later, include nausea and vomiting, indigestion, increased risk of infection, hair loss and severe exhaustion, impaired fertility and organ or tissue damage. How pronounced the side effects of chemotherapy are depends on the substances administered, the dosage, the duration of treatment and the individual condition of the patient.
On the one hand, cancer research has developed combinations of active ingredients with few side effects and, on the other hand, accompanying measures with which the impairment of the patient can be significantly reduced. In some cases, locally limited chemotherapy can also be used, for example by delivering the drugs directly to the liver. A new generation of cytostatics that is currently being tested also gives rise to hope. It is intended to attack the cancer cells in a much more targeted manner while leaving the healthy cells largely undamaged.
