No single treatment for cancer


  • Opinion
  • Sunday, 01 Dec 2019

Cancer treatment options include surgery, chemotherapy, radiation therapy, hormonal therapy, immunotherapy and/or targeted therapy. – Stock image

CANCER is a complex disease with many risk factors involved to form mutations in human genes that control cell growth and death.

These gene mutations can be inherited or acquired through external factors such as environmental exposure or diet. It is thus vital to note that DNA damage exists in our cells all the time.

In most cases, the damage is identified and repaired by cells. If it cannot be repaired, the cell will receive a signal to self-destruct by a pathway called apoptosis.

The dysfunction of DNA repair and apoptosis mechanisms may render accumulations of gene mutations, which may eventually lead to uncontrolled cell growth, and subsequently, cancer development.

When cancer progresses, abnormal growth of the cells may not be confined to the primary site anymore. These cells can continue to spread to other areas of the body via the bloodstream or lymphatic system, through a process known as metastasis (stage 4 cancer).

Metastatic cancer (or advanced stage cancer) accounts for most cancer mortalities, since it is much more difficult to treat. Early cancer diagnosis (before or after symptoms occur), generally increases the chance for successful treatment and patient survival rates. Additionally, it also reduces the cost of treatment compared to treatment at more advanced stages.

Cancer cells used to be our own cells that lost their self-control mechanism for growth. Therefore, our immune systems may find it difficult to differentiate between cancerous cells and normal cells.

Similarly, it is also challenging for scientists to develop a drug that specifically targets cancer cells without harming normal cells. Drug resistance in cancer treatment is also a clinical hurdle.

Treatment

In terms of cancer treatment, there is seldom a single solution for this complicated and rebellious disease. Cancer treatment is strategised based on the various types of cancers and their stages. Doctors usually strategise and propose one type of therapy followed by another for cancer treatment (combinatory therapies).

Treatment options include surgery, chemotherapy, radiation therapy, hormonal therapy, immunotherapy and/or targeted therapy.

The rationale to use combinatory therapy is to enhance treatment efficacy and potentially reduce drug resistance. If the disease is incurable, especially in advanced stages, modern therapy can usually prolong a patient’s life expectancy.

Diet change

Nutritional intervention (as what you usually read on social media) may be complementarily consumed by cancer patients to reduce malnutrition following treatment, thus improving their quality of life.

However, nutritional intervention alone is usually insufficient to stop the growth of cancer cells, hence unable to cure the disease, because cancer is not a purely nutrition-related disease. Dietary adjustment cannot correct the lethal mutation that occurs in cancer cells.

Consult a doctor as early as possible when you notice something unusual about your body or cancer symptoms appear. Regular health checkups can help in early cancer diagnosis as well.

After diagnosis, cancer treatment shouldn’t be delayed because the sooner the disease is treated, the higher the likelihood for successful treatment and better survival.

Dr Ivan Shew Yee Siang is a consultant clinical oncologist at ParkCity Medical Centre.


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