Treatment cancer / malignant tumors

The optimal treatment of cancer/malignant tumors requires a concept that is oftentimes developed and coordinated by several specialists of different medical departments. This is called interdisciplinary therapy. Internal medicine oncologists are the coordinators of these therapeutic concepts, who bring those specialists in. It is crucial to define the aim of cancer treatment, which often means to evaluate if a specific kind of cancer is curable or not. The therapy is chosen accordingly either to cure malignant tumors or to help people live with them as well as possible.

Many malignant tumors necessitate different combinations of treatment. The most important are:

  • surgery
  • radiation therapy
  • hormone therapy (in case of hormone-sensitive cancer)
  • chemotherapy
  • “targeted” substances as medication alternative or addition to chemotherapy
  • immunotherapy
  • special procedures like locally efficacious, minimally invasive treatments, e.g., vertebroplasty
  • symptomatic and supportive therapies

Chemotherapy

“Conventional” chemotherapy eradicates tumor cells by impeding the proliferation of cells or its underlying processes, using the information that cancer cells proliferate faster than most cells of our body. This principle is highly efficient to destroy cancerous cells. However, it is not selective, which means that it targets other, healthy cells of the body as well that feature the same characteristic of quick proliferation.

“Targeted” substances as medication alternative or addition to chemotherapy

Targeted substances do not directly interfere with cell proliferation but attack cancerous cells by affecting other essential metabolic processes. These processes are less active in healthy cells so that they do not suffer as much from side effects as opposed to chemotherapy. The efficacy is also more tumor-specific, but there are also specific side effects. A very good relation between efficacy and side effect have substances that fight genetic changes limited to the particular kind of tumor cells. Whether targeted cancer therapy is suitable, has to be evaluated individually. Important examples are cell surface antibodies, receptors detecting growth, messengers attracting blood vessels for tumor cells as well as so-called tyrosine-kinase inhibitors, which transmit signs of growth within a cell.

Immunotherapy

Immunotherapy stimulates the individual immune system in order to fight cancerous cells, or it supplies the body with anti-cancerous immune cells. This is particularly important in case of allogeneic (cells from a donor) stem cell transplantation.

Symptomatic and supportive therapies

Symptomatic and supportive cancer therapies do not attack tumor cells directly but alleviate or stop symptoms caused by cancer or the primary cancer treatment. Some of the medication used is also applied to reduce the risks of primary cancer therapies. Imperative is the prevention and treatment of infections. Furthermore, blood transfusions can play an important role for some patients. An essential supportive cancer therapy is psycho-oncological care (helps cope with the new situation and find options to decrease social and psychological stress), physical therapy and rehabilitation and the integration of social caregivers into a therapeutic network.