Cancer Surgery & Chemotherapy

Cancer Surgery and Chemotherapy are two key pillars in the treatment of cancer. They are often used in combination with other therapies like radiation therapy, immunotherapy, and targeted therapy, depending on the type and stage of cancer. Here’s an overview of each:

Cancer Surgery

Cancer surgery involves the removal of tumors or cancerous tissues and is often used as a primary treatment when the cancer is localized.

Types of Cancer Surgery

1. Curative Surgery:
   • Aims to remove all cancerous tissue.
   • Often used in early-stage cancers.
2. Debulking Surgery:
   • Removes as much of the tumor as possible when total removal isn’t feasible.
   • Often combined with chemotherapy or radiation therapy.
3. Palliative Surgery:
   • Relieves symptoms or complications caused by cancer (e.g., pain, obstruction).
4. Reconstructive Surgery:
   • Restores appearance or function after curative surgery (e.g., breast reconstruction post-mastectomy).
5. Preventive Surgery:
   • Removes tissues or organs at high risk of developing cancer (e.g., prophylactic mastectomy in BRCA mutation carriers).
6. Minimally Invasive Surgery:
   • Laparoscopic or Robotic Surgery: Smaller incisions, faster recovery.
   • Laser Surgery: Uses focused light beams, often for skin or cervical cancers.
   • Cryosurgery: Freezes and destroys cancer cells, often for early-stage or superficial cancers.

Recovery from Cancer Surgery

• Depends on the type and extent of the surgery.
• Pain management and wound care are critical.
• Monitoring for complications like infection or bleeding.
• Rehabilitation may involve physical therapy or counseling.

Chemotherapy

Chemotherapy uses drugs to kill or inhibit the growth of cancer cells. It may be used as:

1. Primary Therapy: Main treatment for cancers like leukemia or lymphoma.
2. Neoadjuvant Therapy: Given before surgery or radiation to shrink tumors.
3. Adjuvant Therapy: Given after surgery to destroy remaining cancer cells.
4. Palliative Therapy: Relieves symptoms and improves quality of life in advanced stages.

Types of Chemotherapy Drugs

1. Alkylating Agents: Damage DNA of cancer cells (e.g., cyclophosphamide).
2. Antimetabolites: Interfere with DNA and RNA synthesis (e.g., methotrexate, 5-fluorouracil).
3. Antitumor Antibiotics: Interfere with enzymes involved in DNA replication (e.g., doxorubicin).
4. Plant Alkaloids: Inhibit cell division (e.g., paclitaxel, vincristine).
5. Targeted Therapies: Focus on specific molecules or pathways in cancer cells.

Side Effects of Chemotherapy

• Common Side Effects:
  • Fatigue, nausea, vomiting
  • Hair loss
  • Suppressed immune function
  • Anemia and bleeding tendencies
  • Neuropathy (nerve damage)
• Management:
  • Anti-nausea medications
  • Growth factors to boost blood counts
  • Supportive care for symptoms like pain or fatigue.

Combination of Surgery and Chemotherapy

• Neoadjuvant Chemotherapy: Shrinks tumors to make surgery more effective.
• Adjuvant Chemotherapy: Eliminates microscopic cancer cells post-surgery to reduce recurrence.
• Integrated Approach: Used in cancers like breast, colorectal, or ovarian cancer.

Factors Influencing Treatment Choices

• Type, location, and stage of cancer.
• Patient’s overall health and preferences.
• Molecular and genetic characteristics of the tumor.