Staging & Treatment

Staging is the process of identifying where a cancer is located and measuring how far a cancer has spread when it is first diagnosed. Knowing the stage of your cancer helps your doctor to:

• Determine the most effective treatment or combination of treatments for the patient.
• Discuss the prognosis entire health care team and the patients and family
• Determine treatment effectiveness
• Compare larger populations with the same diagnosis to research new, more effective cancer treatments

On the basis of the tests, scans and other procedures ordered by the doctors, the stage of cancer is determined.

The numbered system uses stage numbers to identify how far cancer has spread:

• Stage 0 Cancer : Often referred to as ‘in-situ’ cancer means the cancer cells are still in the place where they started and have not spread at all
• Stage 1 Cancer : Is small and has only spread a little into nearby tissues.It has not spread to any lymph nodes or other body areas.
• Stage 2 and 3 Cancer : Means it is larger and may have spread to nearby tissues or lymph nodes
• Stage 4 Cancer : Has spread to other areas of the body. Stage 4 cancer is also called metastatic cancer or advanced cancer.

In the TNM system, there are three categories:

• T = Tumour
• N = Lymph nodes
• M = Metastases

Each of these categories is given a score, and together these scores show how far the cancer has spread.

The treatment comprises of surgery, chemotherapy, radiation therapy

There are many types of cancer treatment. The types of treatment that you receive will depend on the type of cancer you have and how advanced it is. The most common types of cancer treatment include:

• Surgery: Surgery is a procedure in which a surgeon removes the cancerous tissue or organ and the tissue from the nearby area that might contain cancer cells. Doctors usually opt for surgery if the cancer seems to be contained in one area (localised). Sometimes it’s hard to tell how much surgery is needed until the surgeon sees the extent of the cancer during the operation. Surgery is most successful when the tumour has not spread to other areas.
• Radiation Therapy: Radiation therapy or radiotherapy, often abbreviated RT, RTx, or XRT, is therapy using ionizing radiation in appropriate doses to kill or shrink tumours. Radiation destroys cancer cells or damages them so they can’t grow.
  • External radiation: High-energy rays are aimed from an machine. External radiation is as painless as having an x-ray taken and is usually done in an outpatient setting. The treatment takes very little time and is most often given 5 days a week for 5 to 8 weeks, depending on the size, place, and type of cancer being treated.
  • Internal radiation or Brachytherapy: In some cases, radiation may be given through pellets of radioactive material placed in or near the tumour. Such implants allow a person to get a higher total dose of radiation to a smaller area and in a shorter amount of time than with external radiation.
• Chemotherapy: Chemotherapy is a treatment that includes a medication or combination of medications to treat cancer. The drugs target cells growing at a fast rate such as cancer cells but also affect healthy cells such as those that line your mouth and intestines and hair, causing side effects.
• Immunotherapy: In the last few decades immunotherapy has become an important part of treating some types of cancer. It is a type of biological therapy, which means it uses substances made from living organisms to treat cancer. It may work in these ways:
  • Stopping or slowing the growth of cancer cells
  • Stopping cancer from spreading to other parts of the body
  • Helping the immune system work better at destroying cancer cells
  • There are several types of immunotherapy, including:
    • Monoclonal antibodies
    • Non-specific immunotherapy
    • Oncolytic virus therapy
    • T-cell therapy
    • Cancer vaccines
• Targeted Therapy: Targeted therapy is a special type of chemotherapy that takes advantage of differences between normal cells and cancer cells zeroing in on some of the changes that help them grow, divide, and spread fast and abnormally. Targeted drugs can work to:
  • Block or turn off chemical signals that tell the cancer cell to grow and divide
  • Change proteins within the cancer cells so the cells die
  • Stop making new blood vessels to feed the cancer cells
  • Trigger your immune system to kill the cancer cells
  • Carry toxins to the cancer cells to kill them, but not normal cells

  As researchers learn more about the cell changes that drive cancer, they are better able to design promising therapies that target these changes or block their effects.

• Hormone Therapy: Hormone therapy is a treatment that uses medicines to block or lower the amount of hormones in the body to slow down or stop the growth of cancer especially to treat prostate and breast cancers that use hormones to grow. Hormone therapy is used to:
  • Treat cancer. Hormone therapy can lessen the chance that cancer will return or stop or slow its growth.
  • Ease cancer symptoms. Hormone therapy may be used to reduce or prevent symptoms in men with prostate cancer who are not able to have surgery or radiation therapy.
• Stem Cell Transplant: Stem cell transplants are procedures that restore blood-forming stem cells in people who have had theirs destroyed by very high doses of chemotherapy or radiation therapy. Healthy blood- forming stem cells are infused through a needle in the vein. Once it enters the bloodstream, the stem cells travel to the bone marrow, where they take the place of the cells that were destroyed by treatment. The blood-forming stem cells that are used in transplants can come from the bone marrow, bloodstream, or umbilical cord. Transplants can be:
  • Autologous, which means the stem cells come from the patient themselves.
  • Allogeneic, which means the stem cells come from someone else, a blood relative or someone who is not related but is a close tissue match.
  • Syngeneic, which means the stem cells come from your identical twin, if you have one It is very important that the donor and recipient are a close tissue match to avoid graft rejection. Graft rejection happens when the recipient’s immune system recognizes the donor cells as foreign and tries to destroy them.
• Precision Medicine: Precision medicine is an approach to patient care that allows doctors to select treatments that are most likely to help patients based on a genetic understanding of their disease. This may also be called personalised medicine. Until recently, doctors didn’t know why people with the same diagnosis sometimes respond to the same treatment differently. After decades of research, scientists now understand that
  • Tumours have genetic changes that cause cancer to grow and spread
  • The changes that occur in one person’s tumour cancer may not occur in others who have the same type of cancer
  • The same cancer-causing changes may be found in different types of cancer

  The hope of precision medicine is that treatments will one day be tailored to the changes in each person’s cancer and patients will receive drugs that their tumours are most likely to respond to.

Cancer treatments can cause side effects, problems that occur when treatment affects healthy tissues or organs. Side effects vary from person to person and depend upon the amount or frequency of the treatment, age and other health conditions, the most common known side effects caused by cancer treatment include:

Patients need to take special care of their health during cancer treatment. Here are some general tips:

Cure means that there are no traces of your cancer after treatment and the cancer will never come back. Remission means that the signs and symptoms of your cancer are reduced. Remission can be partial or complete. In a complete remission, all signs and symptoms of cancer have disappeared. If you remain in complete remission for 5 years or more, some doctors may say that you are cured. Still, some cancer cells can remain in your body for many years after treatment. These cells may cause a relapse. It is best to be aware of the risk factors for second cancers and maintain good follow-up health care under advice from your doctor or knowledgeable health care providers.