Surgery
Surgery is the primary method of treatment of most isolated solid
cancers and may play a role in palliation and prolongation of survival.
It is typically an important part of making the definitive diagnosis and
staging the tumor as biopsies are usually required. In localized cancer
surgery typically attempts to remove the entire mass along with, in
certain cases, thelymph nodes in the area. For some types of cancer this
is all that is needed to eliminate the cancer.
Radiosurgery
Radiotherapy may be used following, or in some cases in place of,
resection of the tumor. Forms of radiotherapy used for brain cancer
include external beam radiation therapy, brachytherapy, and in more
difficult cases, such as Gamma knife, Cyberknife.
Gamma Knife Therapy
- Gamma Knife therapy like all radiosurgery, uses doses of radiation
to kill cancer cells and shrink tumors, delivered precisely to avoid
damaging healthy brain tissue. Gamma Knife radiosurgery is able to
accurately focus many beams of high-intensity gamma radiation to
converge on one or more tumors. Each individual beam is of relatively
low intensity, so the radiation has little effect on intervening brain
tissue and is concentrated only at the tumor itself.
- Gamma Knife radiosurgery has proven effective for patients with
benign or malignant brain tumors up to 4 centimeters in size, vascular
malformations such as an arteriovenous malformation (AVM), pain or other
functional problems.[5][6][7][8] For treatment of trigeminal neuralgia, the procedure may be used repeatedly on patients.
- The risks of gamma knife radiosurgery treatment are very low [9] and complications are related to the condition being treated.
Cyber Knife Therapy:
- The Cyber Knife system is a method of delivering radiotherapy, with
the intention of targeting treatment more accurately than standard
radiotherapy. The two main elements of the Cyber Knife are (1) the
radiation produced from a small linear particle accelerator and (2) a
robotic arm which allows the energy to be directed at any part of the
body from any direction.
- Since August 2001, the Cyber Knife system has FDA clearance for
treatment of tumors in any location of the body. Some of the tumors
treated include: pancreas, liver, prostate, .Spinal Lesions, head and neck cancers, and benign tumors.
- None of these studies have shown any general survival benefit over
conventional treatment methods. By increasing the accuracy with which
treatment is delivered there is a potential for dose escalation, and
potentially a subsequent increase in effectiveness, particularly in
local control rates. However the studies cited are so far limited in
scope, and more extensive research will need to be completed in order to
show any effects on survival.
- In 2008 actor Patrick Swayze was among the people to be treated with Cyber Knife radiosurgery.
Chemotherapy
Chemotherapy in addition to surgery has proven useful in a number of
different cancer types including: breast cancer, colorectal cancer,
pancreatic cancer, osteogenic sarcoma, testicular cancer, ovarian
cancer, and certain lung cancers. The effectiveness of chemotherapy is
often limited by toxicity to other tissues in the body.
Radiotherapy & Radiosurgery
Radiation therapy involves the use of ionizing radiation in an
attempt to either cure or improve the symptoms of cancer. It is used in
about half of all cases and the radiation can be from either internal
sources in the form of brachytherapy or external sources. Radiation is
typically used in addition to surgery and or chemotherapy but for
certain types of cancer such as early head and neck cancer may be used
alone. For painful bone metastasis it has been found to be effective in
about 70% of people.
Brachytherapy is a form of radiotherapy where a radiation source is placed inside or next to the area requiring treatment.
Brachytherapy is commonly used as an effective treatment for
cervical, prostate, breast, and skin cancer and can also be used to
treat tumors in many other body sites. Brachytherapy can be used alone
or in combination with other therapies such as surgery, External Beam
Radiotherapy (EBRT) and chemotherapy.
External beam radiotherapy or teletherapy is the most common form of
radiotherapy. The patient sits or lies on a couch and an external source
of radiation is pointed at a particular part of the body. In contrast
to internal radiotherapy, in which the radiation source is inside the
body, external beam radiotherapy directs the radiation at the tumor from
outside the body. Kilovoltage (“superficial”) X-rays are used for
treating skin cancer and superficial structures. Megavoltage (“deep”)
X-rays are used to treat deep-seated tumors (e.g. bladder, bowel,
prostate, lung, or brain).
While X-ray and electron beams are by far the most widely used
sources for external beam radiotherapy, a small number of centers
operate experimental and pilot programs employing heavier particle
beams, particularly proton sources.