Cancer Biology-Lecture 5 (1).pdf

Cancer Biology & Immunology Topic 5 Cancer Treatments-2 Ass. Prof. Dr. Gharieb El-Sayyad Associate Professor of Medical Microbiology & Immunology, Faculty of Pharmacy, Galala University OUTLINE 01 Treatment of cancer by Chemotherapy 02 Radiatio...

Cancer Biology & Immunology Topic 5 Cancer Treatments-2 Ass. Prof. Dr. Gharieb El-Sayyad Associate Professor of Medical Microbiology & Immunology, Faculty of Pharmacy, Galala University OUTLINE 01 Treatment of cancer by Chemotherapy 02 Radiation therapy to treat cancer 03Cancer treatment by Targeted drug therapy  01 Treatment of cancer by Chemotherapy 1-Chemotherapy is a type of cancer treatment that uses drugs to kill cancer cells. 2-Chemotherapy works by stopping or slowing the growth of cancer cells, which grow and divide quickly. 3-Chemotherapy can be used to shrink a tumor so that other treatments, such as radiation and surgery, are possible. 4-Chemotherapy may also help relieve signs and symptoms of cancer by killing some of the cancer cells.  01 Treatment of cancer by Chemotherapy How chemotherapy works against cancer? 1-Chemotherapy works by stopping or slowing the growth of cancer cells, which grow and divide quickly. 2-Chemotherapy is used for two reasons: A)-Treat cancer: Chemotherapy can be used to cure cancer, lessen the chance it will return, or stop or slow its growth. B)-Ease cancer symptoms: Chemotherapy can be used to shrink tumors that are causing pain and other problems.  01 Treatment of cancer by Chemotherapy Which types of cancer does chemotherapy treat? *Chemotherapy is used to treat many types of cancer. For some people, chemotherapy may be the only treatment you receive. But most often, you will have chemotherapy with other cancer treatments. *The types of treatment that you need depend on the type of cancer you have, if it has spread and where, and if you have other health problems.  01 Treatment of cancer by Chemotherapy How chemotherapy is used with other cancer treatments? When used with other treatments, chemotherapy can: 1-Make a tumor smaller before surgery or radiation therapy (neoadjuvant chemotherapy). 2-Destroy cancer cells that may remain after surgery or radiation therapy (adjuvant chemotherapy). 3-Help other treatments work better. 4-Kill cancer cells that have returned or spread to other parts of your body  01 Treatment of cancer by Chemotherapy Chemotherapy can cause side effects? 1-Chemotherapy not only kills fast-growing cancer cells, but also kills or slows the growth of healthy cells that grow and divide quickly. *Examples are cells that line your mouth and intestines and those that cause your hair to grow. Damage to healthy cells may cause side effects, such as mouth sores, nausea, and hair loss. 2-Side effects often get better or go away after you have finished chemotherapy. 3-The most common side effect is fatigue, which is feeling exhausted and worn out.  01 Treatment of cancer by Chemotherapy How your doctor decides which chemotherapy drugs to give you? There are many different chemotherapy drugs. Which ones are included in your treatment plan depends mostly on 1-The type of cancer you have and how advanced it is. 2-Whether you have had chemotherapy before. 3-Whether you have other health problems, such as diabetes or heart disease. How will I know if chemotherapy is working? 1-You will see your doctor often. During these visits, they will ask you how you feel, do a physical exam, and order medical tests and scans. Tests might include blood tests. Scans might include CT, or PET scans. 2-You cannot tell if chemotherapy is working based on its side effects. Some people think that severe side effects mean that chemotherapy is working well, or that no side effects mean that chemotherapy is not working.  02 Radiation therapy to treat cancer 1-Radiation therapy (also called radiotherapy) is a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors. 2-At low doses, radiation is used in x-rays to see inside your body, as with x-rays of your teeth or broken bones.  02 Radiation therapy to treat cancer How radiation therapy works against cancer? 1-At high doses, radiation therapy kills cancer cells or slows their growth by damaging their DNA. 2-Cancer cells whose DNA is damaged beyond repair stop dividing or die. When the damaged cells die, they are broken down and removed by the body. 3-Radiation therapy does not kill cancer cells right away. It takes days or weeks of treatment before DNA is damaged enough for cancer cells to die. Then, cancer cells keep dying for weeks or months after radiation therapy ends.  02 Radiation therapy to treat cancer Types of radiation therapy *There are two main types of radiation therapy, External beam and Internal The type of radiation therapy that you may have depends on many factors, including: The type of cancer. The size of the tumor. The tumor’s location in the body. How close the tumor is to normal tissues that are sensitive to radiation. Your general health and medical history. Whether you will have other types of cancer treatment. Other factors, such as your age and other medical conditions.  02 Radiation therapy to treat cancer Types of radiation therapy 1-External beam External beam radiation therapy comes from a machine that aims radiation at your cancer. The machine is large and may be noisy. It does not touch you, but can move around you, sending radiation to a part of your body from many directions. External beam radiation therapy is a local treatment, which means it treats a specific part of your body. For example, if you have cancer in your lung, you will have radiation only to your chest, not to your whole body.  02 Radiation therapy to treat cancer Types of radiation therapy 2-Internal beam Internal radiation therapy is a treatment in which a source of radiation is put inside your body. The radiation source can be solid or liquid. Internal radiation therapy with a solid source is called brachytherapy. In this type of treatment, seeds, ribbons, or capsules that contain a radiation source are placed in your body, in or near the tumor. Like external beam radiation therapy, brachytherapy is a local treatment and treats only a specific part of your body.  02 Radiation therapy to treat cancer Types of cancer that are treated with radiation therapy External beam radiation therapy is used to treat many types of cancer. Brachytherapy is most often used to treat cancers of the head and neck, breast, cervix, prostate, and eye. A systemic radiation therapy called radioactive iodine, or I-131, is most often used to treat certain types of thyroid cancer. Another type of systemic radiation therapy, called targeted radionuclide therapy, is used to treat some patients who have advanced prostate cancer or gastro-entero-pancreatic neuro- endocrine tumor (GEP-NET). This type of treatment may also be referred to as molecular radiotherapy.  02 Radiation therapy to treat cancer How radiation is used with other cancer treatments **When radiation is combined with surgery, it can be given: 1. Before surgery, to shrink the size of the cancer so it can be removed by surgery and be less likely to return. 2. During surgery, so that it goes straight to the cancer without passing through the skin. Radiation therapy used this way is called intraoperative radiation. With this technique, doctors can more easily protect nearby normal tissues from radiation. 3. After surgery to kill any cancer cells that remain.  02 Radiation therapy to treat cancer Special diet needs while on radiation therapy 1. Radiation can cause side effects that make it hard to eat, such as nausea, mouth sores, and throat problems called esophagitis. 2. Since your body uses a lot of energy to heal during radiation therapy, it is important that you eat enough calories and protein to maintain your weight during treatment.  03 Cancer treatment by Targeted drug therapy What is targeted therapy? 1-Targeted therapy is a type of cancer treatment that targets proteins that control how cancer cells grow, divide, and spread. 2-It is the foundation of precision medicine. As researchers learn more about the DNA changes and proteins that drive cancer, they are better able to design treatments that target these proteins.  03 Cancer treatment by Targeted drug therapy What are the types of targeted therapy? *Most targeted therapies are either small-molecule drugs or monoclonal antibodies. 1-Small-molecule drugs are small enough to enter cells easily, so they are used for targets that are inside cells. 2-Monoclonal antibodies, also known as therapeutic antibodies, are proteins produced in the lab. These proteins are designed to attach to specific targets found on cancer cells. Some monoclonal antibodies mark cancer cells so that they will be better seen and destroyed by the immune system. 3-Other monoclonal antibodies directly stop cancer cells from growing or cause them to self-destruct. Still others carry toxins to cancer cells  03 Cancer treatment by Targeted drug therapy Who is treated with targeted therapy? 1-For some types of cancer, such as chronic myelogenous leukemia, most people with that cancer will have a target for a certain drug, so they can be treated with that drug. *But most of the time, your tumor will need to be tested to see if it contains targets for which there is a drug. 2-Testing your cancer for targets that could help choose your treatment is called biomarker testing. 3-You may need to have a biopsy for biomarker testing. A biopsy is a procedure in which your doctor removes a piece of the tumor for testing.  03 Cancer treatment by Targeted drug therapy How does targeted therapy work against cancer? **Most types of targeted therapy help treat cancer by interfering with specific proteins that help tumors grow and spread throughout the body. This is different from chemotherapy, which often kills all cells that grow and divide quickly. *The following explains the different ways that targeted therapy treats cancer. 1-Help the immune system destroy cancer cells. 2-Stop cancer cells from growing by interrupting signals that cause them to grow and divide without order. 3-Stop signals that help form blood vessels. 4-Deliver cell-killing substances to cancer cells. 5-Cause cancer cell death. 6-Starve cancer of hormones it needs to grow.  03 Cancer treatment by Targeted drug therapy Are there drawbacks to targeted therapy? Targeted therapy does have some drawbacks 1-Cancer cells can become resistant to targeted therapy. *Resistance can happen when the target itself changes and the targeted therapy is not able to interact with it. Or it can happen when cancer cells find new ways to grow that do not depend on the target. *Because of resistance, targeted therapy may work best when used with more than one type of targeted therapy or with other cancer treatments, such as chemotherapy and radiation. 2-Drugs for some targets are hard to develop. *Reasons include the target’s structure, the target’s function in the cell, or both.  03 Cancer treatment by Targeted drug therapy What are the side effects of targeted therapy? 1-When targeted therapy was first developed, scientists thought that it would be less toxic than chemotherapy. But they have learned that targeted therapy can also cause serious side effects. 2-The side effects that you may have depends on the type of targeted therapy you receive and how your body reacts to it.  The most common side effects of targeted therapy include diarrhea and liver problems.  Other side effects might include: 1. problems with blood clotting and wound healing. 2. high blood pressure. 3. Fatigue. 4. mouth sores. 5. nail changes. 6. the loss of hair colour. 7. skin problems, which might include rash or dry skin.  03 Cancer treatment by Targeted drug therapy How is targeted therapy given? 1. Small-molecule drugs are pills or capsules that you can swallow. 2. Monoclonal antibodies are usually given through a needle in a blood vein. Where do I go for targeted therapy? Where you go for treatment depends on which drugs you are getting and how they are given. 1. You may take targeted therapy at home. 2. Or you may receive targeted therapy in a doctor’s office, clinic, or outpatient unit in a hospital. Outpatient means you do not spend the night in the hospital.  03 Cancer treatment by Targeted drug therapy How often will I receive targeted therapy? How often and how long you receive targeted therapy depends on: 1. Your type of cancer and how advanced it is. 2. The type of targeted therapy. 3. How your body reacts to treatment.  You may have treatment every day, every week, or every month.  Some targeted therapies are given in cycles.  A cycle is a period of treatment followed by a period of rest.  The rest period gives your body a chance to recover and build new healthy cells. Dr. Gharieb S. El-Sayyad