Chemotherapy

It is the name given to the treatment with drugs to kill tumor cells in the treatment of cancer.

How does chemotherapy work?

Cancer cells, by their nature, tend to grow and multiply rapidly. Chemotherapy, on the other hand, can stop or slow down this rapid growth and proliferation by reducing it. However, chemotherapy can also damage normal cells, leading to side effects such as hair loss and diarrhea.

For what purposes is chemotherapy used?

Chemotherapy can be used alone in treatment choices that vary according to many characteristics of cancer, or it is usually used in combination with surgical intervention, radiotherapy and other treatment methods.

The situations in which chemotherapy treatment can be used are listed below.

• To minimize the mass before the operation or radiotherapy (neoadjuvant)
• As a preservative (adjuvant) to kill cancerous cells that remain after treatment and cannot be detected by imaging methods)
• Palliative chemotherapy is applied in order to increase the quality of life and prolong life in species that recur or spread to different regions, that is, metastasize.

The doctor decides on the use of chemotherapy. While making the decision, many factors such as the type of cancer, chemotherapy history -if there is any-, and the presence of additional diseases should be considered.

How is chemotherapy applied?

Chemotherapy has many different applications. You can find the most common ones below.

Intravenous (IV)

It is a classic application method. Chemotherapy is given directly into the vein. For this procedure, veins on the forearm or the back of the hand are generally preferred.

Intra-arterial method is the application of the chemotherapy drug directly to the tumor through the artery feeding the cancerous cells. In normal chemotherapy, the given drug first goes to the heart and lungs, and then its density decreases and disperses throughout the body. In cancer that has spread to many organs, intravenous chemotherapy is preferred to distribute the drug throughout the body. However, in some cases, the tumor can be found in a single area or in other organs. In this case, chemotherapy is applied to the artery feeding the mass, and in this way, the drug is sent directly to the target tumor. With this method, more chemotherapy drugs are given to the target and the density is found in the tumor. As a result, side effects are expected to be less than chemotherapy that spreads throughout the body.

Intraperitoneal (IP)

Our organs located in the abdominal area are surrounded by a membrane called peritoneum. Some cancers tend to spread on the peritoneal membrane. For this reason, the method of administering drugs through the peritoneal membranes is used.

Oral (by mouth) in pill form

Oral chemotherapy drugs, which come in pill, capsule, or liquid forms, are taken by mouth. Many smart drugs are taken orally with this method.

Targeted smart drugs

These drugs have been developed as a result of recognizing the growth signal pathways in the cell at the molecular level and succeeding in inhibiting the signals that send warnings to these pathways inside and outside of the cell with some drugs. The most outstanding achievements in the use of targeted smart drugs have been demonstrated in the adenocarcinoma of the lung.

In the process of cancer formation, that is, in carcinogenesis, the reason for the signal transmission pathways that increase growth uncontrollably are the genetic mutations that occur. Recognition of these mutations is very illuminating about the characteristics of the treatment given to individuals, and it has also great importance in improving the results. At this point, as we learn about the molecular pathways and the mutations therein, the number of targeted drugs specially prepared for abnormal changes increases. The increase in the number of these drugs developed, on the other hand, allows individuals with metastatic disease to extend their lifespan and increase their quality of life. At this point, the limited life expectancy provided by chemotherapies in metastatic cancers is significantly prolonged in individuals who are eligible for targeted smart drug therapies.

As a result of analyzes and studies on the DNA of the tumor, changes seen in cancerous cells are revealed. Detection of mutations in individuals with cancerous cells is available in two different ways. Detection of these mutations is important in monitoring the suitability of targeted drugs. The first detection method is molecular tests applied to the tumor taken from the patient together with biopsy. The other method is liquid biopsies, which are now more useful and reliable. This means that tests are performed with a blood sample without the need to take a biopsy from the patient. As a result of the test, the presence of a mutation in the DNA of cancerous cells circulating in the blood is detected and the appropriate treatment is applied. Liquid biopsies generally prevent the recurrence of biopsies in individuals who have previously undergone biopsy but do not have sufficient tissue. Chemotherapy is the preferred method for individuals who are not suitable for targeted therapy as a result of the analyses.

Cancer disease does not only vary between species, but even in individuals with cancer, same type of cancers shows differences. Factors such as each individual’s response to treatment, resilience, general conditions, and presence of concomitant diseases have paved the way for the development of personalized treatments.

Chemotherapy drugs are cytotoxic which means cell-killing drugs. The goal of these drugs is to prevent cells from growing, developing and multiplying. The general feature of cancer cells is their rapid growth and proliferation. For this reason, chemotherapy drugs play an effective role in the treatment of this disease.

What is Brachytherapy? What are the Side Effects?

What is brachytherapy? Brachytherapy is a type of radiotherapy method. In brachytherapy, the radioactive source is placed inside the area that needs healing.

What is Brachytherapy?

Brachytherapy is one of the application methods of radiation therapy, that is, radiotherapy, which is used in the treatment of cancer. Radiotherapy by applying a radioactive source to tissues or tumor beds is the basis of treatment. Radioactive resources can be used temporarily or permanently. In case of temporary application, since the source is removed from the patient, there is no radiation scattering and the patient can continue his life comfortably. During the application, there is usually no pain, depending on the form of the application. However, when necessary, the patient can be given painkillers or sedatives.

Brachytherapy Treatment

There are basically two forms of application in brachytherapy.

Brachytherapy applied to the cavities (Intracavitary)

The radioactive material used in the treatment is located in the anatomical cavities around the cancerous cells. It is generally used in uterine, vaginal, cervical and lung cancers.

Brachytherapy applied to tissues (Interstitial)

The radioactive material used is located in the tissue. It is used in soft tissue, breast and prostate cancers.

Methods Used in Brachytherapy

The administered dose is given to the patient in two different ways.

Temporary Brachytherapy

It is a form of brachytherapy in which the radioactive source is not left inside the patient after the application. It is divided into two basic categories related to the rate of the dose to be applied to the tumor.

High Dose Rate (HDR)

The dose to be administered is given in a short time and quickly. It is more widely used than the other. Radiation is given to tumor beds with the help of a catheter. After the treatment, no radioactive source is left in the body.

Low Dose Rate (LDR)

The dose to be administered is longer and slower. Since the application is long-term, painkillers or other drug supplements can be used. Sensitive people are not allowed into the room as there will be radioactive material during the application.

Permanent Brachytherapy

The radioactive material is placed inside or around the tumor. It is also left permanently. After a while, the radioactive seeds whose activity is over, remain inside the body because it does not leave a permanent side effect on the patient. It is frequently used in prostate cancer.

How is Brachytherapy Applied?

The word brachy means close in Greek and brachytherapy represents treatment at close range. As we mentioned above, in the treatment, the resources are placed near or inside the area to be treated. In some cases, high doses may be required to achieve successful results. This may be difficult to obtain externally, as it may also damage normal tissues. That’s why resources are placed in or near the mass with equipments such as cylinders and needles. The spread of radiation is limited. While the tumor is exposed to high doses of radiation, this amount is kept very low in normal tissues and the damage remains minimized. Brachytherapy treatment is applied in different cancer diseases.

After the surgical operation in uterine cancer, it is applied to the vaginal stump area alone or in addition to external treatment, and in advanced stage cervical cancer, directly after external radiation therapy, into the mass or its immediate surroundings by different tools. It can be applied in the esophagus cancer and bronchial cancer, into the cavity (lumen); and it can be applied in prostate cancer and eye tumor with plaques. In addition, it can be applied directly into the mass formed by cancerous cells through needles during surgical operation, such as in head and neck cancers, soft tissue cancer or early-stage breast cancer.

How Does It Feel During Brachytherapy?

There may be a slight feeling of discomfort during insertion of the brachytherapy resources. It can be applied under anesthesia in patients with low pain threshold.

What Are the Benefits of Brachytherapy?

Brachytherapy provides additional doses when it is not possible to give very high doses due to the tolerance doses of the normal tissues in the irradiated area. In this way, the possibility of tumor control increases and the surrounding normal tissues are protected in the best way, thus reducing the possibility of treatment-related side effects.

What Are the Side Effects of Brachytherapy?

In gynecological cases, it can be applied without anesthesia according to the pain threshold level of the individual. This treatment can be applied in the range of 1-5 sessions, depending on the area applied in general and the treatments received in the previous period. It is essential that the treatment be carried out in a very sterile environment. Side effects differ according to the applied areas. The application is generally made in female cancer diseases. However, the side effects that may occur are listed below.

• Frequent urination due to irritation and infection in the urinary tract
• Burning while urinating, rarely bleeding
• Difficulty in defecation, pain, bleeding, especially in individuals with a history of hemorrhoids
• Tightness and dryness in the vagina
• Although rare, the possibility of another cancer according to treatment (it may occur 10-15 years after the earliest treatment.)

Side Effects of Brachytherapy

After the procedure, the patient does not emit radiation. There is no problem in physical contact. If urinary tract problems occur, it is recommended to drink plenty of water, use antibiotics, and use urinary antiseptics. Sexual life can continue approximately 4-6 weeks after the treatment. Sexual intercourse is recommended to avoid vaginal stenosis. In case of dryness, basic gels that do not contain hormones can be used. Treatment should be carried out by a professional healthcare team and doctor. At this point, the health institution you choose is also very important. You can contact us via the contact page from the menus to have information about brachytherapy and other treatments.