Cancer Treatment

This article was contributed by Dr Eng Jie Yi, Consultant Clinical Oncologist, at Pantai Hospital Melaka. To know more about where and when to see Dr Eng Jie Yiat her clinic, click here.

Cancer treatment involves multiple modalities, including chemotherapy, hormonal therapy, targeted therapy, immunotherapy, radiotherapy, and other cancer treatments. With advancements in treatment and technology, many new therapies have been developed. These innovations aiming to kill cancer cells have significantly improved both survival rates and the quality of life for cancer patients.

Systemic cancer treatment

Systemic treatment refers to a broad category of drug therapies that circulate throughout the body to target and destroy cancer cells wherever they may be. This includes chemotherapy, hormonal therapy, targeted therapy, and immunotherapy.

Chemotherapy

Chemotherapy is one of the main treatments for many types of cancer. Also known as cytotoxic drug therapy, it works by targeting and killing rapidly dividing cells, including cancer cells as well as some normal cells with fast-growing cell cycles in the body.

Chemotherapy treatment can be given for different purposes:

• Neoadjuvant treatment: To shrink the tumor before surgery or radiotherapy.
• Adjuvant treatment: To eliminate microscopic cancer cells after surgery and reduce the risk of cancer recurrence.
• Concurrent treatment: Given alongside radiotherapy to enhance its effectiveness.
• Palliative treatment: To control cancer, relieve symptoms, and improve the patient’s quality of life in advanced stages.

Chemotherapy is usually given in cycles, and the number of cycles depends on the type of cancer and treatment goals. It can be administered in several ways, including:

• Intravenously (through a vein)
• Via an infusion pump
• Subcutaneously (under the skin)
• Orally (in tablet or capsule form)

In most cases, chemotherapy can be done on an outpatient basis, although some patients may require hospital admission for treatment, depending on the regimen and their condition.

Doctors monitor the effects of chemotherapy through regular blood tests to check for changes in blood cells, monitor organ function, and adjust doses if necessary.

Chemotherapy Side Effects

Common chemotherapy side effects may include:

• Fatigue
• Sore mouth or throat due to ulcers
• Poor appetite and altered taste
• Nausea and vomiting
• Constipation or diarrhoea
• Low blood counts, increasing the risk of infection

Other possible side effects include temporary hair loss, numbness or tingling in the hands and feet (peripheral neuropathy), allergic reactions, and potential fertility issues, depending on the specific chemotherapy drugs used.

Hormonal therapy

Hormonal therapy, also known as endocrine therapy or hormone therapy, is a treatment that works by reducing or blocking the body's hormone production to slow or stop the growth of hormone-sensitive cancers.

It is often used in combination with other treatments such as chemotherapy, or radiotherapy, depending on the type and stage of cancer. Hormonal therapy is commonly used in cancers that are driven by hormones, including breast cancer, prostate cancer, and uterine (endometrial) cancer.

Targeted therapy

Targeted therapy is a form of precision medicine that differs from conventional chemotherapy. It works by specifically targeting cancer-related molecules or proteins that are involved in cancer cell growth and survival, thereby minimising damage to healthy cells.

There are two main types of targeted therapy:

• Small molecule drugs – usually taken orally.
• Monoclonal antibodies – typically administered intravenously or via subcutaneous injection.

Targeted therapy is used for cancers that have specific genetic mutations or protein expressions that can be identified and targeted. Therefore, before starting this treatment, doctors will often send a sample of the cancer tissue for genomic or molecular testing to determine if the patient is a suitable candidate.

Targeted therapy is commonly used to treat:

• Breast cancer
• Lung cancer
• Colorectal cancer
• Ovarian and endometrial cancers
• Melanoma
• Cholangiocarcinoma (bile duct cancer)
• Thyroid cancer

In some cases, targeted therapy may be given in combination with chemotherapy or radiotherapy to enhance treatment effectiveness.

Immunotherapy

Immunotherapy is considered one of the newer and promising approaches in cancer treatment. It works by enhancing and regulating the patient’s immune system to recognise and destroy cancer cells more effectively. Immunotherapy can be used on its own or in combination with other treatment modalities such as chemotherapy, targeted therapy, or radiotherapy to help control or even cure certain cancers.

It is used to treat a variety of cancers, including lung cancer, breast cancer, skin cancer (such as melanoma), liver cancer, kidney cancer, and others. Immunotherapy is typically administered intravenously through the bloodstream.

In general, immunotherapy is better tolerated than traditional chemotherapy, but it can cause unique side effects related to immune system activation. These may vary depending on the type of drug and individual response. It’s important to discuss potential side effects and benefits with your oncologist before starting treatment.

Localised cancer treatment

For some types of cancer, localised treatments may be possible. This means that the treatment can accurately target specific areas of the body, rather than affecting the entire body systemically.

Radiotherapy

Radiotherapy is a cancer treatment that uses high-energy X-rays or other forms of radiation to destroy cancer cells. It is considered a local treatment, as the radiation is precisely targeted to the specific area where the cancer is located, minimising damage to surrounding healthy tissue.

External beam radiotherapy

External beam radiotherapy includes several advanced techniques such as:

• 3D Conformal Radiotherapy (3D-CRT)
• Intensity-Modulated Radiation Therapy (IMRT)
• Volumetric Modulated Arc Therapy (VMAT)
• More precise forms like Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiotherapy (SBRT)

These techniques allow for highly accurate targeting of the tumor while minimising exposure to surrounding healthy tissues.

Each treatment session typically takes about 15 to 30 minutes, and most patients receive it on an outpatient basis. The experience is like having an X-ray or CT scan—painless and non-invasive.

Importantly, patients do not become radioactive after receiving external beam radiotherapy and can safely interact with others, including children and pregnant women.

Brachytherapy

Brachytherapy is a type of internal radiation therapy in which a device is placed inside the patient’s body as close to the tumor as possible. This device is connected to a radiation source that delivers a high dose of radiation directly to the cancerous area while minimising exposure to surrounding healthy tissue.

Brachytherapy is commonly used to treat cancers such as:

• Cervical cancer
• Endometrial (uterine) cancer
• Breast cancer
• Certain head and neck cancers
• Prostate cancer

Radioactive iodine therapy (RAI)

Radioactive iodine therapy is a treatment that uses a radioactive isotope, Iodine-131, to treat hyperthyroidism (an overactive thyroid gland) and certain types of thyroid cancer. It works by destroying overactive or cancerous thyroid tissue.

Before undergoing RAI therapy, patients are usually required to follow a low-iodine diet for several days to enhance the effectiveness of the treatment. After receiving the therapy, patients must take specific precautions to limit radiation exposure to others, especially in the first few days, as small amounts of radiation may be emitted from the body.

Explore Treatment Options with Confidence

At Pantai Hospital Melaka, our team of expert oncologists is dedicated to providing personalised care and advanced treatment options tailored to your needs. With cutting-edge technology and compassionate support, we’re here to help you face cancer confidently.

Your health is our priority—schedule a consultation today.