Historically chemotherapy was the predominant treatment for advanced cancers, however within the last decade there has been an explosion of new systemic therapies that complement chemotherapy. These are often treatments that divide significantly fromchemotherapy in terms of how they are delivered and potential side-effects.
Some of these include:
These include:
Clinical trials are running in Cairns and throughout the world which are likely to o’er more treatment options in the coming years.
Systemic therapies fall into 3 categories of use:
Chemotherapy drugs have multiple different mechanisms of action, although they are all cytotoxic (i.e. kill cells). Many of these were discovered in nature (plants and bacteria) and are now synthesised in laboratories. As they kill a percentage of cells with every treatment, multiple doses are often required, with a rest period in between to allow the normal cells to recover.
Small molecule inhibitors are often given as tablets, and are able to get into the cell by naturally occurring pathways to inhibit the targeted cellular machinery that is leading to the growth of the cancer.
Monoclonal antibodies are given intravenously or subcutaneously (under the skin) and move via the bloodstream to the targeted cells and often bind irreversibly to the target cell receptor and thus inhibit them.
Most chemotherapy and antibody therapy is given intravenously via a drip in the arm in an oncology day unit. Treatment times may range from 5 minutes up to 5 hours depending on the type of treatment. Other therapies are given orally as tablets. There are some treatments that are given locally, such as treatment to the bladder in early bladder cancer.
Patients are seen as an initial consult and a discussion and plan is formulated for treatment and ongoing follow-up. Chemotherapy is given in the oncology day unit at Cairns Private Hospital and patients are free to go home the same day. Side effects are managed under the close supervision of the treating medical oncologist and nursing staff.