Evolving Cancer Treatment

Risk is the probability that a certain something will happen. When we talk about cancer, risk is most often used to describe the chances that a person will develop cancer. It is also used to describe the probability that cancer will recur to bite us from behind. Understanding the risk of having cancer also helps researchers and doctors improve the health of many people. When scientists, for example, discovered that smoking increased the risk of lung cancer, a worldwide anti-smoking campaign was initiated.

Cancer is the name for a group of more than 100 diseases in which cells begin to grow out of control. It can develop almost anywhere in the body and can be spread through the bloodstream to distant parts of the body. These body parts may include the bones, liver, lungs, brain or breast. Even if the cancer spreads, it is still named after the area where it started.

Since the 1950’s, the mainstay of systemic cancer treatment has been cytotoxic chemotherapy. Localized cancer treatment involves other modalities such as surgery and radiation but for now, we will focus on systemic treatment. Cytotoxic chemotherapy are anticancer drugs, that are administered intravenously, orally or through injections, that kill cells, especially cancer cells. The drug interrupts these cancer cells as they through the division cycle (the cell cycle) or mitoses. Cancer cells actively divide on a daily basis. When the cancer cells are dividing, this is when they are most susceptible to being destroyed by the chemotherapy. Chemotherapy also affects some normal cells that also divide but not as frequently or rapidly when compared to cancer cells. The normal cells that are affected include blood counts, skin and hair, and epigastric and gastrointestinal lining cells. Through the years, side effects from chemotherapy have markedly diminished due to better medications that prevent and counter them.

By the 1980’s, targeted therapy was introduced as a treatment for cancer. It is a type of cancer treatment that targets the changes in cancer cells that help them grow, divide and spread. The earliest targeted therapies are the oral hormonal agents that target the estrogen and progesterone receptors in breast cells. These hormonal agents antagonize the binding of estrogen and progesterone in the receptors thus inhibiting the signal for the cell to divide.

Through the years, many other targeted agents have been developed. Some of these agents target compounds within a cancer cell called tyrosine kinases, which, when hit by the targeted therapy, causes a disruption of cell signaling and prevents cell division. Other targeted therapies are monoclonal antibodies that upon binding to receptors on cancer cell surfaces also lead to inhibition of cell signaling. Targeted therapies are NOT cytotoxic and as such do not affect the normal dividing cells as chemotherapy does. Their side effects are unique to each kind of targeted therapy and are markedly less when compared to that of chemotherapy. These targeted therapies may be given along with chemotherapy and even as maintenance medications after chemotherapy. Other targeted therapies such as oral tyrosine kinase inhibitors may be given as single agents.

The doctor’s recommendations on cancer treatment options depends on the type and stage of cancer, possible side effects, the patient’s preferences and overall health. In cancer care, doctors from different specialties work together with the patient to come up with the patient’s overall treatment plan that, more often than not, combines different types of treatments. This is called a multidisciplinary team approach.

The Cancer Program of The Medical City Clark adopts a personalized and customized approach to cancer prevention, early detection, diagnosis, and management which makes use of the multidisciplinary team approach. The program applies innovative molecular technologies in diagnosis and treatment for truly customized care. With a full appreciation that no two individuals are alike – regardless of similarities between two patients diagnosed with the same type of cancer – TMC Clark’s program applies an individualized approach to the diagnosis and treatment of cancer based on the patient’s profile at the molecular level.

Recently, immunotherapy has been gaining rapid advances in the treatment of cancer. Immunotherapy medications render the cancer cells more susceptible to being destroyed or killed by the patient’s own immune killer T cells. They may be given along with chemotherapy and also as single agents. Their side effects are also unique in mimicking immune related diseases. Doctors are also looking into giving vaccines along with chemotherapy. With all the rapid advances in systemic cancer treatment, survival rates, even for stage IV cancers, are increasing. Those who have the early warning signs of cancer are encouraged to immediately consult their primary physicians..

This is The Medical City Clark’s Cancer Coordinating Center’s comparative advantage over the other cancer centers in the region. A multidisciplinary team develops a personalized treatment plan according to the profile and preferences of the patient who is the focus of the cancer program. The team is made up of doctors from different specialties, cancer specialists, nurses and other specialized health care professionals. Family members are also an important part of the team. Another unique service offering of the Cancer Center is the multidisciplinary meeting. During the multidisciplinary meetings with members of the care team, the patient and his family members are encouraged to ask questions, express reservations and get involved in making important decisions concerning the patient’s care plan.

When dealing with cancer, a daily dose of inspiration can make a big difference in the outlook on life. There is no time for negative energy with cancer. You need to be around with people who are capable of looking after you and TMC Clark’s Cancer Coordinating Center will be there all throughout to inspire, challenge and make you better. Get in touch and consult with us at The Medical City Clark. Just contact (045) – 300 – 8888 or 09164488046 for inquiries.

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FRANCISCA ROSARIO E. TAN, MD
She took her MS in Clinical Medicine major in Medical Oncology in the University of the Philippines in 2005 – 2007. She also took her post graduate training; fellowship training in Adult Medical Oncology at the Philippine General Hospital (2005 – 2007), fellowship training in Geriatric Medicine at St. Luke’s Medical Center – Quezon City, residency in Internal Medicine and Medical Internship at UP – PGH, Manila. Currently Dr. Tan is the Head of The Cancer Center and a regular consultant of the Department of Internal Medicine at The Medical City Clark.

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