Evolution of Cancer Treatment
Domlur, Bengaluru Feb 20, 2017
Cancer and its treatments have evolved over the decades. Also, over time there have been interesting patterns of changes in the attitude of patients, hospitals, care givers and doctors in the management of this illness.
For instance, earlier in a typical medical college hospital, a cancer patient on diagnosis and basic therapy was sent to the “cancer ward”, which by any stretch of imagination, was not a good place to be in. It had all terminally ill, suffering patients, with minimal care and in a pathetic state. Today, cancer does not instil the kind of fear and loathing as it did some 25 years ago. There are specialized cancer hospitals, an ever growing number of Oncology specialists that has reduced this fear.
The key word in Onco therapeutics today is PRECISION.
- In surgery, gone are the days when a whole organ removal was the norm if it was cancerous. Radical mastectomy in breast cancer or amputations in limb sarcomas were routine earlier; now it is extremely rare for anyone to think of these surgeries as default methods.Today we do just lump removal breast surgeries, followed by a sentinel axillary lymph node biopsy instead of a morbid axillary clearance. We use technology like laparoscopy and Robotic surgery to minimize normal tissue trauma and accurately dissect cancer tissues. The outcomes are better and patients retain near normal functions of the organ in question.
- In Radiation treatments, primitive whole organ radiation techniques were done with great damage to skin and surrounding normal tissues. The doses to be given were sub-optimal as we feared life-threatening damage to tissues. We had a situation where treatment was below par, and complications were high. With the advent of modern technology like linear accelerators, multi leaf collimations, IMRT and IGRT, precision radiotherapy which delivers maximal doses to the tumour with minimal spill to nearly organs help in better tumour control and tolerance of treatments.
- In Chemotherapy treatments, the norm today is to give targeted drugs to specific cancers. “One size fits all” does not operate any more. By examining the pathology of the cancer tissues one can, in certain cancers like Colon and lung, determine which specific drug works best for that type of cancer. This means that we have excluded giving the patient all the vague and unnecessary medication which would not have worked but complicated the patient’s health with its side effects. Also, most of these drugs deliver its payload at the cancer sites specifically and possibilities of affecting normal tissues are very low. Once again, maximal cancer cell damage, minimal normal tissue damage to ensure better compliance!
Added to all this is the phenomenonal growth of support systems. There are excellent pain relief therapeutics, better understanding of palliative care and more awareness. Also, one specific area which has evolved in the last 3 years or so which was non-existent all this time is the sphere of HOME HEALTH CARE.
At least 40% of all cancer related treatments, either in its active therapy form or in palliative mode, need not be done at hospitals. Home care is ideal for these conditions. Management of pressure sores, delivering injections/infusions of fluids, supplements, bone strengthening agents, colony stimulating factors, EPO, etc., can be ideally done at home. One need not go and wait endlessly in hospitals for instance, a chemo port heparin flush! So also, sensitive matters like colostomy care is best done at home. Portea brings this care to patient’s homes making cancer care smoother.
It won’t be wrong to quote that we have managed to reduce the scourge of cancer from a killer disease to a chronic ailment like diabetes or hypertension! As John Diamon said “Cancer is just a word, not a long sentence”.
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