Cancer drugs and various medical procedures to treat it

Cancer is a non-communicable disease that is deadly in Indonesia, following the position of heart disease which is in the top rank. The main cause of cancer is DNA mutation in cells which the risk is increased by various factors. So, what are the ways to treat cancer? Is it just taking anti-cancer drugs? Come on, find out more in the following review.

Cancer drug options and medical procedures

Cells that grow do not die and existing cells continue to divide without control is the hallmark of cancer cells. These abnormal cells then form tumors in certain types of cancer. Without treatment, cancer cells can spread (metastasize) and damage the function of the surrounding tissue.

Now, there are various ways to treat cancer, including:

1. Chemotherapy

Chemotherapy or chemo is a cancer treatment using drugs that kill abnormal cells in the body. These drugs are grouped based on how they work, chemical structure, and their interactions with other drugs.

Various types of drugs are used in chemotherapy, including:

• Alkylating agent

These drugs prevent cells from dividing by damaging their DNA. Usually, it is used to treat lung cancer, breast cancer, and leukemia. Examples of alkylating agents are busulfan, temozolomide, mechlorethamine, altretamine, lomustine, and chlorambucil.

• Antimetabolite

These drugs interfere with the DNA and RNA in cells so they don't divide. It is usually used to treat colon cancer, ovarian cancer, and breast cancer. For example, anti-cancer drugs of this type are azacitidine, fludarabine, pralatrexate, and cladribine.

• Anti-tumor antibiotics

These drugs are not like antibiotics to treat bacterial infections, but change the DNA in cancer cells so they don't grow and divide. For example, drugs in this class are anthracyclines (daunorubicin, epirubicin) or non-anthracyclines (bleomycin, dactinomicin).

• Topoisomerase inhibitors

This drug can interfere with the topoisomerase enzyme which causes chemical reactions in living cells. It is usually used to treat pancreatic cancer, lung cancer, and colorectal cancer. For example, these types of drugs are camptothecins (topotecan, irinotecan) and epipodophyllotoxins (teniposide).

• Mitosis inhibitors

This drug for malignant tumors works by stopping cells from dividing. Usually used to treat lymphoma cancer and blood cancer. Examples of this type of drug are docetaxel, vinorelbine, and paclitaxel.

• Corticosteroids

This drug is useful for preventing side effects of chemotherapy, such as nausea and vomiting. The drugs used for example are prednisone, methylprednisolone, and dexamethasone.

Chemotherapy not only kills cancer cells but also surrounding healthy cells. However, most of the normal cells can recover after the therapy is done.

2. Radiotherapy

How to deal with cancer can also be with radiotherapy. This cancer therapy does not use drugs, but radiation rays. Therefore, this treatment is also known as radiation therapy.

Unlike imaging tests with radiation, this treatment uses high levels of radiation. That way, the tumor can shrink and cancer cells can die. These abnormal cells are then broken down and eliminated from your body.

However, this therapy cannot immediately kill cancer cells with one treatment. It takes several treatments to make the cancer cell's DNA damaged and die.

Alternative cancer treatments besides chemotherapy are divided into two types, namely external radiation and internal radiation (brachytherapy). Determining which type of cancer therapy is for you, will depend on the type of cancer, the size and location of the tumor, and the overall health of the body.

3. Biological therapy

The next way to treat cancer is biological therapy. This therapy involves using laboratory-produced substances that act against cancer cells. Cancer therapy is divided into various types, including:

Immunotherapy

The next way to treat cancer that is still based on drugs is immunotherapy. Immunotherapy is a form of cancer treatment that uses the human immune system to fight back.

The way it works is to stimulate your own immune system to stop the growth and multiplication of cancer cells in the body. Then, provide special man-made substances that have immune-like functions and properties, for example immune proteins.

This treatment is an alternative when the cancer does not respond well to radiation or chemotherapy. Immunotherapy methods as a way to treat cancer include:

• Immune checkpoint inhibitors. Giving special drugs so that immune cells respond more strongly to cancer. You do this by reducing the effect of immune checkpoints in the body, which is the part of the immune system that regulates the immune system so that it is not too strong.
• T cell transfer therapy. Treatments to increase the natural ability of T-cells to fight cancer. Initially, the immune system cells around the tumor are taken, selected the most active against cancer, and engineered in the laboratory to work better. Furthermore, these cells are put back into the body by injection in a vein.
• Monoclonal antibodies. This method of treating cancer is also called therapeutic antibodies. This treatment uses a protein from the immune system created in a laboratory that is designed to mark and bind to cancer cells so that the immune system is easier to recognize and destroy.
• Cancer drug vaccines. This treatment is a vaccine that works to increase the immune system's response to cancer cells. However, it should be noted that vaccines in immunotherapy are different from vaccines that are generally used to prevent disease.
• Immune system modulators. This way of treating cancer works by increasing the response of the immune system more specifically, whose job it is to fight cancer cells.

Just like other treatments, immunotherapy also causes side effects such as body fatigue, skin problems, fever, and body aches.

Target therapy

Targeted therapy is a treatment that is targeted to block the growth and spread of cancer cells with drugs. This treatment is different from chemotherapy because it can specifically destroy cancer cells through drugs. Unlike chemotherapy, this cancer treatment does not affect the healthy cells around the cancer.

Although it targets directly to kill abnormal cells and is thought to be able to treat cancer, this method still has weaknesses. Weaknesses such as cancer cells become resistant to certain drugs, only effective in dealing with tumors with specific genetic mutations, and cause diarrhea, liver problems, and blood clots.

4. Hormone therapy

Hormone therapy is a cancer treatment that slows or stops the growth of cancer that uses hormones. Hormone therapy is also called endocrine therapy. Usually, this therapy is used as a way to treat breast cancer and prostate cancer.

The goal of this treatment is to shrink the tumor before radiation therapy is carried out. Then, it is also used as an additional cancer treatment so that the cancer does not come back.

Cancer therapy treatments are very diverse, including taking medication that contains hormones, injecting hormones in the body, and surgical removal of organs, such as the ovaries or testicles. Unfortunately, this treatment only works on cancers that require the body's hormones and cause side effects such as decreased sex drive, impotence, vaginal dryness, and fatigue.

5. Cancer surgery

How to treat cancer that is very common besides taking medication is surgery. This medical procedure is performed to remove cancer cells from spreading to the surrounding healthy tissue.

There are various types of surgery for cancer, including:

• Cryosurgery

Operation using cold energy in the form of liquid nitrogen to freeze cancer cells and destroy them. Usually done to treat cervical cancer.

• Electrosurgery

Surgery uses high-frequency electric currents to kill cancer cells in the skin or mouth.

• Laser surgery

Surgery relies on the aid of high-intensity light rays to shrink malignant tumors and remove cancer cells.

• Operation Mohs

Surgery on sensitive skin areas, such as eyelid cancer. This operation is performed by removing the cancer cells in the form of layers with a scalpel.

• Laparoscopic Surgery

A surgical procedure that involves making small incisions and inserting a special device equipped with a camera as well as a cutter to remove cancer cells.

6. Radionuclear therapy

Radionuclear therapy is a medical procedure that involves heat from nuclear power which can be used to treat diseases, one of which is cancer.

Before starting, you will undergo body imaging to map the location of the cancer cells and their possible metastases. The team of doctors will then prepare the type and dose of radioisotope drugs (containing radioactive compounds) according to your physical condition.

After that, the drug is then injected directly into a vein. Within a few minutes, this drug will travel to the location of the targeted cancer cells. Furthermore, you must be isolated in a special room and undergo hospitalization so that you do not pollute the surrounding environment until the levels of radioactive materials are below normal limits (harmless).

During treatment, you may need to wear a mask or other protective equipment that will block radiation from affecting other parts of your body. Side effects of radionuclear therapy include nausea, vomiting, mood swings, and body discomfort.

7. Ultrasound therapy

In early 2020, the American Institute of Physics revealed that using ultrasound with the correct frequency can destroy cancer cells. Ultrasound therapy from Caltech relies on exposure to heat energy from ultrasound at low intensity to kill cancer cells without damaging surrounding healthy cells.

Then, also known as ultrasound therapy as HIFU or high intensity focused ultrasound. This therapy uses a method of action that is inversely proportional to the ultrasound therapy from Caltech, which uses high frequencies.

HIFU cannot penetrate solid bone or air, so it can only be used in certain types of cancer, one of which is prostate cancer. However, until now researchers are still making deeper observations about its effectiveness as well as its side effects. The use of this treatment in Indonesia is still not common.

8. Operation biopsy

Biopsy is known as a cancer diagnosis test. However, a biopsy is also a cancer treatment because the tumor removal process can be done at once when the cancer is checked.

Biopsy surgical biopsy procedure is used to remove part of an area of ​​abnormal cells (incisional biopsy) or remove the entire area of ​​abnormal cells (excisional biopsy). Usually the doctor will provide local or general anesthesia, and ask you to be hospitalized for a few days.

Apart from cancer drugs, there is also palliative care

Palliative care is a treatment that is not intended to cure disease. However, helping patients reduce symptoms or reduce other factors that exacerbate symptoms so that their quality of life can be better. Examples of palliative care that cancer patients typically follow are:

1. Art and music therapy

The next cancer treatment, does not use drugs but with artistic activities. Although it does not directly cure cancer cells, this treatment helps patients manage their emotions, such as sadness, anger, fear, and anxiety.

By managing emotions better, the patient's mental health will also improve and will have an impact on the immune system so that it can improve the patient's quality of life for the better.

In this therapy, patients will be filled with various activities, such as listening to music, singing, playing musical instruments, pouring their emotions into lyrics and songs, drawing, painting, sculpting, or making various crafts.

2. Animal therapy (pet therapy)

Animal therapy also does not use drugs to treat cancer. Apparently, a decrease in current stress pet therapy caused by the production of endorphins.

This hormone can relieve pain and make a person more comfortable and happy. If concluded, pet therapy can help cancer patients in several ways, namely:

• Reducing pain, allowing the patient to reduce the use of painkillers
• Reducing stress due to illness and also the treatment that is carried out
• Reducing the symptoms of fatigue that usually affects cancer patients

Cancer treatment for the elderly (seniors)

Unlike younger adults, the elderly do not have many cancer treatments. This is because usually the elderly also have other chronic diseases, such as diabetes and heart disease. As a result, the side effects that can arise from treating the elderly are far more serious.

Cancer treatment that can be undertaken by the elderly is taking medication through chemotherapy, following radiotherapy, and surgical removal of cancer cells. However, the side effects will be more severe, so both the doctor and the family should carefully consider treatment options.

The various side effects that appear during cancer treatment in the elderly include:

• Disruption of heart, kidney and lung function.
• Decrease in the number of white blood cells, red blood cells, and platelets.
• Digestion is disturbed and there is damage to the nervous system.