Dr. Shruti Kate

PRECISION MEDICINE

Precision oncology allows for targeted therapy based on a person’s molecular and genetic characteristics. We know that cancer is an extremely heterogeneous disease – both between patients and even within the cancer cells of an individual patient. Precision oncology is based on the premise that there is no “one size fits all” treatment.The goal of precision medicine is simply to deliver the right cancer treatment to the right patient at the right dose and the right time. An early example in solid tumor oncology is the ability to test for HER2 positivity as defined as fluorescent in situ hybridization–based gene amplification or immunohistochemistry to demonstrate overexpression of the protein. Positive results predict response to trastuzumab-based therapies, whereas HER2-negative tumors do not derive benefit from this approach.

SURGERY

Curative or primary surgery is usually done when cancer is found in only one part of the body, and it’s likely that all of the cancer can be removed. It is called "curative" because the purpose of the surgery is to remove all of the cancer completely. In this case, surgery can be the main treatment. It is given along with other treatments like chemotherapy or radiation therapy given before or after the operation.

CHEMOTHERAPY

The word "chemotherapy" ("chemo") is used to for medicines or drugs that treat cancer. Traditional or standard chemotherapy uses drugs that are cytotoxic, meaning they can kill tumor cells. Chemotherapy can be intravenous or oral. Chemotherapy drugs target cells at different phases of the cell cycle. Understanding how these drugs work helps to predict which drugs are likely to work well together. Cancer cells tend to form new cells more quickly than normal cells and this makes them a better target for chemotherapy drugs. However, chemo drugs cannot differentiate between healthy cells and cancer cells. Hence, normal cells are also affected along with the cancer cells, and this causes side effects. Each time chemotherapy is given, it means trying to find a balance between killing the cancer cells (in order to cure or control the disease) and sparing the normal cells (to lessen side effects).

Most normal cells will recover from the effects of chemo over time. However, cancer cells are mutated (not normal) cells, and they usually do not recover from the effects of chemo. This is why chemotherapy is efficient against many types of cancers.

RADIATION THERAPY

Radiation therapy is one of the most common treatments for cancer. Radiation may be used alone or with other treatments, such as surgery, chemotherapy, hormones, or targeted therapy. Radiation works by making small breaks in the DNA inside cells. These breaks keep cancer cells from growing and dividing and cause them to die. Nearby normal cells can also be affected by radiation, but most recover with time.

IMMUNOTHERAPY

Immunotherapy is treatment that uses a person's own immune system to fight cancer. Immunotherapy drugs boost or change body’s tumour directed immunity and enable natural defences of immune system so it finds and attacks cancer cells.

TARGETED THERAPY

Targeted therapy is a type of cancer treatment that uses drugs or other substances to precisely identify and attack certain types of cancer cells. A targeted therapy can be used by itself or in combination with other treatments, such as traditional or standard chemotherapy, surgery, or radiation therapy.

Because of their targeted action, these drugs have an effect on the cancer cells and mostly do not harm the normal, healthy cells.

STEM CELL /BONE MARROW TRANSPLANT

A bone marrow transplant is a medical treatment that replaces your bone marrow with healthy cells. The replacement cells can either come from your own body or from a donor.

A bone marrow transplant is also called a stem cell transplant or, more specifically, a hematopoietic stem cell transplant. Transplantation can be used to treat certain types of cancer, such as leukemia, myeloma, and lymphoma, and other blood and immune system diseases that affect the bone marrow.

CAR-T CELL THERAPY

Chimeric antigen receptor (CAR) T-cell therapy is a way to get immune cells called T cells (a type of white blood cell) to fight cancer by changing them in the lab so they can find and destroy cancer cells. CAR T-cell therapy is also sometimes called cell- based gene therapy, because it involves altering the genes inside T cells to help them attack the cancer.

This type of treatment can be very helpful in treating some types of cancer, even those that are refractory to other treatments.

Treatments

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