There are 4 major types of treatment for cancer — radiation, chemotherapy (often called chemo), surgery and biologic therapies. Chemotherapy uses very strong drugs, and radiation therapy uses high energy waves to treat the disease by killing cancer cells. Radiation therapy is targeted to localized cancer i.e., specific organs in the body where cancerous tissue is present. Chemotherapy can be used when cancer cells have spread to other parts of the body.
Chemotherapy may use a single drug or a combination of drugs called combination chemotherapy to treat cancer. There are over 100 chemotherapy drugs available which are used stand alone or as a combination of certain drugs. This video gives a graphic description of how cancer cells develop to form a tumor and what chemotherapy does to destroy the tumor.
Radiation therapy is much stronger than X-rays and uses very high levels of energy waves to kill cancer cells. This video, similar to the one above, describes radiation therapy:
Depending on the type of cancer, both chemotherapy and radiation therapy could be a standalone treatment, or one in combination with surgery to treat cancer.
Chemotherapy is given according to the type and stage of cancer. When used to treat the entire body, the cancer has usually spread to more than one part of the body. Doctors use chemotherapy to destroy cancer cells, control or slow the spread of cancer cells and reduce symptoms like pain associated with tumors. Chemotherapy is administered in various ways:
- Injection: Given as a shot
- Intra-arterial: Often used in case of a tumor. A catheter is inserted through the femoral artery in the groin which is directed to the main artery in the body and directed to the tumor.
- Intravenous: The drugs are inserted through a vein in the body.
- Topical: Applied on the skin as a cream.
- Oral: In the form of pills or liquids taken orally.
Radiation therapy is given to treat one part of the body. It is given with the intent of curing cancer or reducing the symptoms associated with cancer. The various ways radiation therapy is administered are:
- External Beam Radiation Therapy: High energy waves are sent from equipment outside the body to the tumor.
- Internal Beam Radiation Therapy: High energy waves are sent from a device inside the body. The implanted device can be in the form of a wire or a pellet. The implant can be temporary or permanent, and is either removed once all the radiation is given off, or can be left inside as it is harmless.
- Injections: A radioactive substance is injected inside the body.
- Oral: The radioactive substance must be swallowed by the patient.
There is no one way to recommend one form of treatment over the other. Chemotherapy or radiation therapy is prescribed by the doctor after careful analysis of the patient’s unique symptoms, type and stage of cancer. The decision is made keeping in mind the best outcome for the patient.
Both chemotherapy and radiation therapy may produce immediate and long term side effects. Along with killing cancer cells, both the treatments tend to kill even the healthy cells, although they repair themselves in time. The damage to the healthy cells causes side effects. These treatments are also hazardous to healthy people, and require special handling during preparation and administration. Family members of patients receiving chemotherapy and radiation therapy have to take special precautions to not come in contact with and get affected by drugs and radiation levels.
Chemotherapy causes fatigue, nausea, vomiting, loss of appetite and changes in fertility levels. It decreases the amount of red blood corpuscles in the body, causing anemia and a decrease in white blood corpuscles lowering immunity. Side effects also include hair loss, pain and a change in emotional patterns.
Radiation therapy causes similar side effects of fatigue, nausea, vomiting, appetite loss and emotional changes. Additionally, radiation therapy can cause changes to the skin that comes in contact with radiation. Radiation therapy applied to the head can cause hair loss and difficulty swallowing when applied to the neck area.
The length of chemotherapy depends on the type and severity of cancer. Several factors go into determining how the treatment will be given. Chemotherapy is usually given in 2 or 3 week cycles with periods of rest to help the body recover. The treatment may be given for 3 to 6 months and can extend beyond that.
Low doses of chemotherapy given into the bloodstream via a pump can be administered from home and require hospital visits to refill the pump. Intravenous Chemotherapy is administered as an outpatient and can take up to a few hours.
Hospital stays are required for high-dose-intensive treatments which need to be given in a controlled environment, and for treatments that requires the doctor to monitor reactions. Hospital stays can range from a few days to a few weeks.
The duration of radiation therapy depends on the location, type and stage of cancer. If the total dose of radiation is low but the dosage per-individual session is high, then radiation therapy may be administered over 2-3 weeks. Therapy where dosage per individual treatment is lower but the amount of total radiation is high can be administered over 9 weeks.
Radiation is often administered 5 times per week; sometimes even twice a day. Cases which need internal radiation may need a total of 2-6 treatments more than 2 weeks apart. Treatment of thyroid cancer via injections or orally may require only one administration.
Effect on Daily Routine
Some people are able to go about their daily routine and keep working during chemotherapy as well as radiation therapy. The side effects, however, may require changes in schedule. Schedules may often need to be changed for treatment and hospital visits, but disruptions in daily life can be minimized by getting treatment late in the day or just before the weekend.
Cancer can be in partial or total remission. In partial remission, some of the signs and symptoms of cancer are not seen. In total remission, none of the signs and symptoms of cancer are seen. Remission is often referred to in 5, 10, 15, and 20 year terms. It does not, however, mean that the cancer is cured. There is a possibility of a relapse after a few years of remission.
Effectiveness of chemotherapy and radiation therapy depend on the cancer profile which differs on a case by case basis. Chemotherapy and radiation are normally effective in the early stages of cancer. In cases of chronic cancer, chemotherapy may not cure but can help control the disease for months or years. Sometimes immunity is developed to certain drugs and in case of a relapse; doctors might take a different approach to the treatment and switch drugs. Sometimes radiation therapy might be the only way to treat cancer and can help with remission. In cases where there is a relapse, radiation therapy may not cure but can control symptoms. Depending on the case, cancer can go into remission for 5, 10, or even 20 years. There is no way of saying how long a cancer will stay in remission. Once in remission, doctor visits are required at scheduled intervals to monitor the progress. The longer the remission period, better are the chances that cancer will not relapse.
The cost of chemotherapy depends on the type of drug prescribed, frequency, and length of treatment. Most often, chemotherapy drugs are taken in combination with other drugs. Drugs can cost from $4,000 to $10,000 for one month of supply. Though some drugs may be covered by insurance companies and Medicare, some insurance companies refuse to cover costs because of the high prices of oral chemotherapy drugs. Some insurances cap oral drugs at an annual limit of $5000 which, barely covers the monthly supply. There are alternative IV drugs available which get better insurance coverage, but they are invasive and are administered through a port implanted in the body.
Radiation therapy costs can differ based on the level of radiation and the cost of healthcare in a particular region. Radiation therapy can start at $1,700 for a single treatment and advanced radiation therapy treatments like Cyberknife can cost up to $4000 per treatment. Radiation therapy may be covered by Medicare and insurance depending on the insurance provider.
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- Oral chemotherapy - Kaiser Health News
- Chemotherapy for breast cancer - Mayo Clinic
- Radiation costs - umich.edu
- Duration of radiation - Hart to Heart
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- Radiotherapy - patient.co.uk