Cancer is a condition with a gradually increasing incidence that affects all organs and systems, and may be fatal.
The world cancer statistics by International Agency for Research on Cancer (IARC) showed that 19.3 million new cancer cases (18.1 million excluding non-melanoma skin cancer) and approximately 10.0 million cancer deaths (9.9 million excluding non-melanoma skin cancer) worldwide ) have occurred as of 2020. When the reported rates of 19.3 million new cases and 10.0 million deaths in 2020 are compared with the rates of 18.1 million cases and 9.6 million deaths in 2018, it is estimated that the cancer burden in the world has increased.
Turkey has proven itself about cancer treatment. Treatments performed by following current guidelines increase the survival of patients and provide a beacon of hope for patients suffering from this relentless disease.
RumiPulse offers the most appropriate treatment option for cancer patients , in collaboration with oncologists and surgeons proven in the international medical literature.
Oncological surgeries- Surgical oncology is a field of cancer care that focuses on using surgery to diagnose, stage, and treat cancer. Oncological surgeons may also perform palliative procedures in order to help to control the pain, to increase the comfort level and to manage symptoms and adverse effects of the cancer. Eligibility of a patient for the surgery depends on factors such as the tumor type, tumor size, tumor location, cancer stage and grade as well as physical eligibility including age and other medical conditions.
Many patients may have cancer surgery along with other treatments such as chemotherapy, radiotherapy and/or hormone therapy. Non-surgical treatments may be used before the surgery (neoadjuvant therapy) or after the surgery (adjuvant therapy) to help prevent cancer growth, metastasis or recurrence.
The surgery may be performed through minimally invasive techniques such as laparoscopy or robotic surgery depending on the type of cancer, the size of the tumor and its location. Other conditions may require open surgical procedure which is more invasive with larger incisions. An oncological surgeon may can work with other doctors and specialists in order to help to reduce the pain and adverse effects and speed recovery after surgery.
Chemotherapy- Chemotherapy is treatment of the cancer with drugs. The drugs used in chemotherapy damage cancer cells and prevent the growth and reproduction of cancer cells. Conventional chemotherapies can be more effective when used alone or with some drug combinations. Therefore, chemotherapy cures may include multiple drugs. Chemotherapy is used to treat the disease depending on the type and stage of cancer, to prevent the spread of the tumor, to slow down its growth, to kill cancer cells that have spread from the organ to other parts of the body, and to improve some symptoms of cancer. Chemotherapy may be the only option in some cases. The chemotherapy is applied sequentially or simultaneously with other treatments (surgery and radiotherapy) depending on the stage of the disease. Chemotherapy can be used to reduce the size of the tumor before surgery or to prevent the proliferation and spread of cancerous cells that may remain in the body after surgery. The same procedures are applicable before and after radiotherapy, chemotherapy can also be implemented at the same time as radiotherapy.
Drugs used for chemotherapy may be administered intravenously and orally. Intravenous administration of chemotherapy drugs is performed by mixing these drugs into physiological saline and infused within a certain period. Patients who need a longer period for chemotherapy may be hospitalized and after a while, the problem of finding a vein may occur. Since long-term administration of some drugs into the vein is necessary, chemotherapy is applied for such drugs through devices called "catheters" or "ports" that allow direct administration of the drug into the main vein. Chemotherapy treatment process is also carried out at home in some patients with drugs to be taken orally in pill form. It is necessary to have detailed information about how to use these drugs and to consult a doctor for possible questions. The pills taken at home are just as important as the drugs administered intravenously, and their incomplete or incorrect use may adversely affect the treatment process. Chemotherapy may also be performed by administering the drug into some body areas. These are abdominal space, pleura and urinary bladder. All these treatment procedures must be done in a fully equipped oncology center and under the control of a medical oncologist.
What are the types of chemotherapy drugs? How does these drugs affect?
The 'classical chemotherapy' procedures remain valid; however, many innovative methods from smart drugs to molecular applications increase the success rates.
The feature of the cancer cell for prevention of growth signals
'Target-oriented smart drugs' which are frequently used for each type of cancer are used in two routes: oral pills or intravenously. These drugs are in the form of small molecules or antibodies, and they attach to the growth receptors of the cancer cell and prevent the tumor from receiving a growth stimulus. The drugs with minimal or controllable adverse effects such as nausea and hair loss both offer an effective treatment option to the patient and increase the patient's quality of life during the treatment process. Smart molecules and targeted drugs are used in many types of cancer, especially in brain tumors, and cancers of the head and neck, lung, stomach, breast, kidney and prostate. The presence of these drugs does not eliminate the existence of conventional chemotherapies. Smart drugs and chemotherapies are combined in some types of cancer.
Treatment support with immune system cells
There are many cancer-fighting cells in the human body. However, it is known that the activation of these cells may occur up to a certain point. The immunotherapies which have been mentioned frequently in recent days use the immune system cells of the patient for this purpose. In this way, cancer is fought by using the patient's own immune system and defense mechanisms. This method called immunotherapy aims to treatment the disease by directing the cancer-fighting cells of the human body to the cancer tissue. The pharmaceuticals administered to the patient in the form of solution for infusion within 2-3 week periods provide effective results in malignant melanoma and lung cancer which are very aggressive types of skin cancer Furthermore, immunotherapies may also be used for the treatment of renalcancers and lymph cancers, and yield successful results in many types of cancer.
Molecular therapies for inoperable patients
Molecular treatments that prolong life and improve the quality of life of patients for some types of cancer are important options for patients who do not have the chance to undergo surgery. Molecules that can detect the characteristics or weaknesses of the cancer cell reach the cancerous area when administered to the body through the mouth or vein. Treatments that ensure that healthy tissues are minimally affected and tumor cells are destroyed with an effective dose contribute to the regression of the disease and prolongation of life in liver tumors with microscopic-sized beads containing high-energy radioactive yttrium-90. Radioactive treatments are also used in "neuroendocrine" cancers which may originate from many organs such as stomach, pancreas, intestine, thyroid and lungs. Molecular therapies such as actinium and lutetium are considered as one of the highly effective treatment options for advanced prostate cancer and neuroendocrine cancers. The radioactive peptides administered intravenously stick on the targeted cells, highly spread beams and destroy the cancer cells. These treatments may stop the progression of the disease in people who do not have a chance for surgery and have extensive tumor presence. Radioactive iodine treatment which is known as "atom therapy" and the most common of "radionuclide therapies", comes to the forefront in thyroid cancers. The procedure is administered orally in the form of capsules or liquids after surgery in the vast majority of patients diagnosed with thyroid cancer.
The drug selection is made by a medical oncologist according to the type of tumor, prevalence of the tumor, age, general condition of the patient and other existing diseases (such as heart disease, high blood pressure, diabetes, kidney disease). The drug doses and dosing frequency are also decided by the medical oncologist. The duration and frequency of treatment depends on the scheme determined according to the disease and the patient's condition. The duration and frequency may be changed by the medical oncology specialist according to the response obtained with the treatment and the side effects. A period of 3 to 4 weeks are the most common in general; however, in some treatment schemes, an application is made once a week or every two weeks. The most important point about the timing of chemotherapy is regular and timely performance of the treatment as much as possible. When the treatment intervals are extended without any need, this period may enable the tumor to recover itself and gain strength by gaining resistance to drugs. The tumor continues to grow and spread, the chance of treatment of the disease decreases or becomes more difficult. Therefore, it is very important for patients to proceed in line with the recommendation of their doctor regarding chemotherapy appointments. One of the requirements of the treatment process is that the patient does not change the treatment process during periods of not feeling well and takes the necessary drugs to be used at home.
Radiotherapy
Radiation is a special type of energy transported by waves or particles. It can be produced by special devices or released by substances called radioactive. This energy is used in medicine for imaging purposes as well as to treat cancer and some other diseases. Special devices are needed to direct the radiation to the organ. The use of high-dose radiation energy for treatment is called "radiotherapy" or "radiation therapy". Radiotherapy is used;
-To reduce the size of the tumor before the surgery;
-To clear the cancer cells that might have remained at microscopic level after the surgery;
-Solely as the primary treatment of the disease;
-Directly in combination with chemotherapy without surgery.
Radiotherapy may also be implemented in order to reduce the complaints such as pain and bleeding in case of incurable diseases. This type of treatment is called "palliative treatment". The patient takes of her/his clothes and wears a gown. Therefore, it is advisable to wear outfits that may be taken off easily.
The radiotherapy technician uses previously marked lines on the patient's skin to identify the treatment area. The patient should sit on a special chair or lie on a treatment table. Although each session requires 15 to 30 minutes in the treatment room, the delivery of the radiation dose takes place in 1 to 5 minutes. External radiotherapy is painless like an X-ray.
The patients do not need to hold their breath during the procedure and only normal breathing is sufficient. In radiotherapy sessions, it is important that the defined dose is administered in the most sensitive way and the rays reach the right place in the body, the patient's position is not deteriorated throughout the treatment, the same position is created in each treatment, and the environment is immobilized in order to ensure the comfort of the patient in the best way. In this process called immobilization, accessories such as head-neck masks, vacuum mattresses, under-knee stabilizers or shoulder pullers may be used depending on the treated area.
The radiotherapy technician leaves the room before the beam is delivered. The devices are controlled from a small area close to the therapy area. The patient may watch the process through a monitor or window. When the patient speaks meanwhile, her/his voice can be heard from the loudspeaker and the technician can be contacted. A noisy environment may occur when radiotherapy devices rotate around the treatment area at different angles due to their large structures. However, it should be noted that the devices are operated by the relevant technicians and their operation is checked regularly. Any questions about the treatment room or devices may be asked to the technician or doctor.
