Treatment Options By Cancer
Radiation therapy is delivered in a number of different ways. Each patient is treated with the type of radiation most appropriate to his or her type of cancer and/or situation. The following is a more detailed explanation of radiation therapy as it relates to particular types cancer.
BLADDER
Bladder cancer is found more often in men than women, and primarily affects those over the age of 40. Risk factors include tobacco use, exposure to carcinogens in the workplace, and being infected with certain parasites.
Caucasians are twice as likely to be diagnosed with bladder cancer than African Americans and Hispanics. Family history of bladder cancer increases one's chances of getting the disease.
Surgery, including the removal of the bladder, is performed in cases of bladder cancer when practical. Because some patients may to try and preserve the function of the bladder, radiation, many times in conjunction with chemotherapy, may be given. Bladder function will never return to normal, but in many cases after treatment with radiation and chemotherapy, bladder function is acceptable.
CARTI utlizes 3-D conformal therapy and in certain cases, IMRT, in its treatment of bladder cancer.
BONE
Cancer that begins in the bone is called primary bone cancer. It is rare. Secondary bone cancer, or metastatic bone cancer, is cancer that has resulted from the spread or metastasis to the bone from another part of the body.
Osteocarcinoma is the most common form of metastatic bone cancer and because it is generally found in new tissue within growing bones is most often found in people between the ages of 10 and 25.
CARTI is the only provider of radiation therapy to pediatric patients in the state. CARTI utlizes 3-D conformal treatment and brachytherapy in its treatment of metastatic bone cancer.
BRAIN
Primary brain tumors are those tumors that originate in the brain. They can develop at any age, but primarily affect two age groups: children ages 3 to 12 and adults ages 40 to 70. Roughly 17,000 Americans are diagnosed with brain tumors each year.
CARTI is the only source in Arkansas for the treatment of pediatric brain tumors with radiation.
Primary brain tumors differ from cancer that originates elsewhere in the body and spreads to the brain. The process of a cancer originating elsewhere in the body and travelling through the bloodstream or lymphatic and then growing in normal tissues elsewhere in the body is called metastasis.
Surgery is the most common form of treatment for brain tumors, although if the tumor can't be removed completely without damage to the surrounding tissue, radiation or chemotherapy may be used to treat the remaining cancerous cells.
CARTI utilizes 3-D conformal therapy on brain tumors and in some cases IMRT if the tumor is adjacent to a radiation-sensitive vital structure.
BREAST
Breast cancer is estimated to affect one of eight American women, most between the ages of 40 and 50. The most common type of breast cancer begins in the lining of the ducts (ductal carcinoma), which connect the nipples to the rest of the breast. Another type is called lobular carcinoma and develops in the lobules, which contain the bulbs that produce milk.
Risk factors include family history and genetic alterations, but for the most part, cause is not known. It is known that early detection and treatment dramatically increase survival rates. Regular self exams and mammograms after the age of 40 are recommended for all women, especially for those with a family history of the disease.
CARTI treats breast cancer, in most cases, with a conventional 3-D conformal plan. In some cases, Forward Planned Intensity Modulation is used to provide an even distribution of radiation.
COLORECTAL
Colorectal cancer is a term used to describe cancers of the colon and rectum, and as such represents one of the more common forms of cancer.
Colorectal cancers occur in both men and women, and almost always in people over the age of 50. They are linked to diets high in fat and low in fiber.
Each of the three modalities of cancer treatment are utilized with colorectal cancers. Surgery is used to remove tumors of the rectum when practical. In other cases, a combination of 3-D conformal radiation, sometimes preoperative, and chemotherapy is used.
ESOPHAGEAL
The esophagus is the tube that connects your throat to your stomach. Esophageal cancer consists of squamous cell carcinomas and adenocarcinomas.
The exact causes of this form of cancer aren't known, but it occurs more often in men than in women and usually in people over the age of 60. Risk factors include:
• Use of tobacco and smokeless tobacco.
• Chronic or heavy use of alcohol.
• Patients who have survived other forms of head-and-neck cancer have an increased chance of developing cancer in the area again, including esophageal cancer.
Esophageal cancer can spread to the lymph nodes, which are a part of the immune system, and can therefore spread to any other part of the body.
Surgery may be performed to remove lymph nodes or all or part of the esophagus. But depending on the stage of the cancer, 3-D conformal radiation and sdmetimes IMRT are utilized at CARTI.
GYNECOLOGICAL
There are five types of Gynecological Cancers.
CERVICAL
The cervix is the lower part of the uterus. It forms a canal that opens into the vagina, which leads to the outside of the body. Roughly 15,000 women annually are diagnosed with cervical cancer in America.
Precancerous changes of the cervix are not painful, therefore not detected unless by a pelvic exam and Pap test. Early detection is critical in the diagnosis of cervical cancer. Regular gynecological exams from a medical doctor are the best way to prevent a diagnosis of cervical cancer.
Risk factors include a lack of access to medical care, which eliminates the opportunity for early screening; smoking, and non-monogamous sex.
Surgery is used to remove cancerous tumors of the cervix when possible, but radiation therapy is utilized when surgery is not appropriate. CARTI treats cervical cancer with 3-D conformal therapy and brachytherapy.
ENDOMETRIAL
Endometrial cancer is cancer of the endometrium, which is the lining of the uterus. It differs from cancer of the uterus, which is called uterine sarcoma.
Risk factors include the treatment of breast cancer with tamoxifen, and the taking of the estrogen hormone (alone, without progesterone). Warning signs of endometrial cancer include unusual vaginal discharge or pain in the pelvic area.
Surgery is the most common mode of treatment for endometrial cancer, but depending on the stage of the disease and other cancers, radiation treatment via 3-D conformal therapy or brachytherapy may be used.
OVARIAN
Ovarian cancer is cancer that begins in the cells that constitute the ovaries, including surface epithelial cells, germ cells, and the sex cord-stromal cells. Cancer cells that metastasize [hot link] from other organ sites to the ovary (most commonly breast or colon cancers) are not then considered ovarian cancer.
Ovarian cancer represents roughly 4 percent of cancer cases in women yet ranks fifth as a cause of cancer deaths. Most ovarian cancer patients are not diagnosed until the disease is advanced in stage.
The disease is most often treated with surgery or a combination of surgery and chemotherapy. In those rare cases where radiation is deemed appropriate, CARTI utilizes 3-D conformal radiation therapy and brachytherapy in the treatment of ovarian cancer.
UTERINE
Uterine cancer entails three types - cervical cancer, which is cancer of the lower portion of the uterus (the cervix); endometrial cancer, cancer of the uterine lining called the endometrium, and uterine sarcoma.
Uterine sarcomas are cancerous tumors in the muscles of the uterus. Uterine sarcoma is the rarest form of uterine cancer. It is genrally treated by surgical removal of the uterus (a hysterectomy), and in some cases postoperative radiation may be necessary. If surgery is not practical, 3-D conformal radiation therapy is generally utilized in uterine sarcoma cases at CARTI. In some cases where radiation is used for uterine sarcoma, IMRT is utilized.
In addition, Low Dose Rate (LDR) and High Dose Rate (HDR) radiation implants may be used either preoperatively or postoperatively with or without external beam radiation. The type of radiation used in these cases depends on the tumor stage and risk factors associated with the patient.
VAGINAL
Vaginal cancer consists of two types: squamous cell carcinoma [hot link], usually found in women between 60 and 80, and adenocarcinoma, found in women between 12 and 30. Vaginal cancer is rare, making up only about 2 percent of all gynecological cancers.
Radiation is generally the appropriate treatment for vaginal cancer. CARTI utlizes 3-D conformal therapy and brachytherapy in its treatment of the disease.
HEAD AND NECK
Cancer of the oral cavity (mouth), pharyngeal cancer, also known as throat cancer, and cancer of the larynx make up the major components of what are referred to as cancers of the head and neck. Such cancers make up roughly 5 percent (about 60,000 cases) of all cancers diagnosed in America annually.
Most head and neck cancers are squamous cell carcinomas [hot link]. Major risk factors include:
• Use of tobacco and smokeless tobacco.
• Alcohol use.
All three modalities of cancer treatment - radiation, surgery and chemotherapy - are used in the treatment of head and neck cancers. CARTI utilizes 3-D conformal treatment and IMRT to treat head and neck cancers. Radiation is sometimes administered in conjunction with chemotherapy.
HODGKIN'S
Hodgkin's disease is one of two types of lymphoma - cancer of the lymphatic system. It is rare in America, comprising less than 1 percent of cancers diagnosed.
Hodgkin's is diagnosed usually in the following age groups: 16-34 and over 55. Research indicates that it is more common in those with a family history of the disease.
Treatment of Hodgkin's depends on a variety of factors including stage, size, number and location of the affected lymph nodes, age and general health. At CARTI, we utilize traditional 3-D conformal therapy.
LUNG
Lung cancer is the second-most common form of cancer among both men and women in America (colorectal is the most common). Smoking accounts for roughly 90 percent of all lung cancers, and is the most preventable form of cancer.
Studies have suggested that men who quit smoking by age 50 reduced their risk of lung cancer by almost two-thirds compared to men still smoking at age 75.
Radiation and chemotherapy are used to treat the disease. CARTI utilizes traditional 3-D conformal treatment in addition to brachytherapy.
MELANOMA
Melanoma represents the most serious form of skin cancer, and the number of melanoma diagnoses has doubled in America in the past 20 years.
Melanoma occurs when the pigment cells become malignant. It can occur on any skin surface and even in the eye, and in rare cases in the digestive tract, lymph nodes and other areas where melanocytes, or cells that produce pigment, are found.
Melanoma is found most often in men between the shoulders and hips or the head or neck. In women, it usually develops on the lower legs. It is rare in African Americans and others with dark skin. Melanoma risk increases with age, but it affects all ages of people.
Several types of surgery and chemotherapy can be utilized, depending on factors such as stage and location. In some cases, radiation is administered postoperatively.
At CARTI, melanoma is treated with high dose radiation where there may be a high risk of lymph node involvement. Otherwise, it is treated with conventional 3-D conformal plans.
OTHER CANCERS
CARTI treats more than 75 types of cancer a year, many of them rare and others in most cases better suited for different modalities of treatment. Such examples include bile duct, gallbladder, kidney, liver and testicular cancers, as well as multiple myeloma, lymphoma and leukemia.
Usually, these cancers are not treated with radiation but in certain circumstances, radiation therapy is necessary.
CARTI specializes in radiation therapy, which can be administered in conjunction with chemotherapy or surgery, either preoperatively or postoperatively.
Radiation can be delivered through traditional external beam methods - 3-D conformal treatment through brachytherapy, the implantation of radioactive seeds, or through IMRT, an external beam procedure that pinpoints the delivery of radiation.
CARTI's radiation oncologists work with patients to determine the best course of radiation treatment delivery for their particular cancer.
PANCREATIC
The pancreas produces hormones that help the body utilize energy that comes from food. It release insulin and other hormones into the bloodstream when needed. Several different types of cancer can develop in the pancreas, and most of those begin in the ducts that carry pancreatic fluids.
Pancreatic cancers may metastasize into surrounding organs. It is estimated that roughly 26,000 new cases of pancreatic cancer are diagnosed annually in the United States.
Pancreatic cancer is treated with surgery, chemotherapy and radiation, and in most cases where radiation is used, it is delivered in conjunction with chemotherapy. CARTI utilizes 3-D conformal therapy in its treatment of pancreatic cancers.
PROSTATE
Disease of the prostate, the walnut-sized organ that surrounds the uretha and produces fluid that becomes part of semen, has become quite common, especially in older men.
Since opening our doors over 30 years ago, CARTI has treated almost 10,000 prostate cancer patients, which is the vast majority of all prostate cancer patients treated with radiation therapy in Arkansas.
Statistics reveal that more than half of American men between the ages of 60 and 70 and up to 90 percent of men between 70 and 90 have symptoms of benigh prostate disease - a condition called benign prostatic hyperplasia (BPH). The condition is rarely life threatening, but may require treatment to relieve symptoms, which include difficulty urinating and frequency of urination.
Prostate cancer is the most common form of cancer in men, and is the third-most treated cancer at CARTI. Men with a family history of prostate disease should receive annual digital rectal examinations in conjunction with a prostate-specific antigen (PSA) test annually beginning at the age of 40. Otherwise, men 50 and older should be screened each year.
Radiation is the most common form of treatment for prostate cancer. CARTI utilizes 3-D conformal therapy, IMRT and brachytherapy in its treatment of prostate cancer.
SKIN
Skin cancer is the most common form of cancer among Americans. About one million Americans are diagnosed annually. Some estimates say that 40 to 50 percent of Americans who live to age 65 will experience a form of skin cancer at least once.
Anyone can get skin cancer, but those at higher risk are people with fair skin that freckles easily, especially those with red or blond hair and blue or light-colored eyes.
Basal cell carcinoma and squamous cell carcinoma are the two most common kinds of skin cancer. Basal cell carcinoma accounts for more than 90 percent of all skin cancers diagnosed in the U.S. It is slow growing and seldom spreads, making it highly treatable. Likewise, squamous cell carcinoma is not apt to spread. Still, it is important that skin cancers be detected early.
The main risk factor for skin cancer is exposure to the ultraviolet (UV) rays of the sun and other sources of UV radiation, such as sun lamps and tanning booths. The risk of developing skin cancer increases in areas that receive high levels of UV radiation from the sun. The highest rates of skin cancer worldwide are found in South Africa and Australia.
Surgery is often used in the treatment of skin cancer depending on stage and location of the cancer. Radiation is also a common treatment. CARTI utilizes a superficial treatment called electron beam radiation to treat most cases of skin cancer.
STOMACH
Stomach cancer, also called gastric cancer, begins in the stomach, which is actually a sack-like organ in the abdomen that mixes food with gastric juice to begin the process of digestion.
It is estimated that roughly 24,000 Americans are diagnosed with stomach cancer annually, but over the past 60 years, the death rate associated with stomach cancer has drastically decreased.
Risk factors for stomach cancer include:
• Age. It is more likely to develop in people over 55.
• Gender. Men are affected twice as often as women.
• Race. Stomach cancer is more common in African American than in Caucasians.
• Geography. The disease is more prevalent in other parts of the world where the diet consists of foods preserved by smoking, salting, pickling or drying.
Research suggests that other risk factors may include exposure to a certain type of bacteria - Helicobacter pylori; exposure to certain workplace dusts and fumes; stomach surgery and various conditions that may result in a lower-than-normal amount of digestive juices, and possibly smoking.
Surgery is most often used in stomach cancer cases to remove tumors whenever practical. However, in cases where the tumor is advanced or has involved lymph nodes, radiation is often delivered postoperatively in conjunction with chemotherapy.
The primary type of treatment used at CARTI for stomach cancer is 3-D conformal therapy.
