There are many kinds of malignant tumors, with different types, different tissues and organs involved, different stages of disease, and different responses to various treatments. Therefore, most patients need comprehensive treatment. The so-called comprehensive treatment refers to the comprehensive use of surgery, chemotherapy, radiotherapy, immunotherapy, traditional Chinese medicine treatment, interventional therapy, microwave therapy and other methods according to the patient's physical condition, tumor pathological type, and scope of invasion, in order to greatly improve the cure. Rate and improve the patient’s quality of life.
1. Surgical treatment
In theory, if the tumor cells are completely removed by surgery, the cancer can be cured. For early or earlier solid tumors, surgical resection is still the preferred treatment. According to the purpose of the operation, it can be divided into the following types:
(1) Radical surgery Because the malignant tumor grows fast and there is no envelope on the surface, it has no obvious boundary with the surrounding normal tissues, and the local infiltration is obvious, and it can metastasize through the lymphatic vessels. Therefore, surgery must completely remove the tumor and its surrounding normal tissues and lymph nodes that may be invaded. This kind of surgery is suitable for patients with a limited tumor range, no distant metastasis, and good physique. According to the scope of resection, it is divided into tumor resection, extensive resection, radical resection and extended radical resection.
(2) Palliative surgery has a wide range of tumors and has metastasized and cannot undergo radical surgery. In order to relieve pain, maintain nutrition and prolong life, you can only remove part of the tumor or perform some symptomatic surgery, such as fistula Surgery, short circuit of the digestive tract and other operations. Advanced tumors can be resectioned to reduce tumor burden and lay the foundation for future radiotherapy, chemotherapy or other treatments. For example, most ovarian tumors can be removed palliatively for advanced ovarian cancer, and a second operation after chemotherapy to remove residual lesions can significantly prolong the survival of patients.
(3) Diagnostic surgery Obtain tumor pathological examination specimens through different surgical methods, such as puncture and extraction of small pieces of tissue during surgery. For deep visceral masses, open chest, open abdomen, or craniotomy is required. After the intraoperative pathological examination is confirmed, therapeutic surgery is performed immediately.
(4) Preventive surgery is used for precancerous lesions to prevent them from becoming malignant or developing into advanced cancer. For example, patients with familial polyposis of the colon can benefit from preventive colon resection, because such patients will not have their colon removed. After the age of 40, about half can develop into colon cancer, and after the age of 70, almost 100% can develop into colon cancer. Cervical conization can be used for severe heterogeneous hyperplasia of the cervix to prevent cervical cancer. BRCA1 and BRCA2 have mutations in hereditary breast cancer family members, and bilateral breast prophylactic resection is feasible.
(5) Surgery for metastases. For a single lung, liver, bone and other metastases, resection can still achieve a 5-year survival rate. For example, the primary lung cancer has only a single bone metastasis, and the primary lung cancer can be completely resected, the resection of the primary tumor plus the metastasis can be performed at the same time or successively.
2. Chemotherapy
It is to treat cancer with drugs that can kill cancer cells. Since the biggest difference between cancer cells and normal cells is rapid cell division and growth, the principle of action of anti-cancer drugs is usually to inhibit the growth of cancer cells by interfering with the mechanism of cell division, such as inhibiting DNA replication or preventing chromosome separation .
Most chemotherapeutic drugs are not specific, so they will kill the normal tissue cells that undergo cell division at the same time, so they often damage healthy tissues that need to divide to maintain normal functions, such as intestinal mucosal cells.
However, these tissues can usually repair themselves after chemotherapy. Because some drugs can be used in combination to obtain better results, chemotherapy often uses two or more drugs at the same time, which is called "comprehensive chemotherapy".
Most patients undergo chemotherapy in this way.
3. Radiation therapy
Also called radiotherapy and radiation therapy, it uses radiation to kill cancer cells and shrink tumors. Radiation therapy can be via external radiation therapy or in vivo proximity radiation therapy. Since cancer cells grow and divide faster than normal cells, radiation damages the genetic material of the cells to prevent the cells from growing or dividing, thereby controlling the growth of cancer cells. However, the effect of radiotherapy can only be limited to the area that is irradiated. The goal of radiotherapy is to destroy all cancer cells as much as possible while minimizing the impact on neighboring healthy tissues. Although radiation exposure can cause damage to both cancer cells and normal cells, most normal cells can recover from the damage caused by radiotherapy.
4. Targeted therapy
Targeted therapy has been effective in treating certain types of cancer since the late 1990s. It can treat cancer as effectively as chemotherapy, but its side effects are much reduced compared with chemotherapy.
It is also a very active research field at present. The principle of this treatment is to use small molecules with abnormal or disordered proteins that specifically fight cancer cells, such as tyrosine phosphatase inhibitors, to treat non-small cell lung cancer with sensitive mutations of EGFR (epidermal growth factor receptor) , The curative effect is significant, but the emergence of drug-resistant genes is currently the main obstacle hindering further improvement of curative effect.
5. Immunotherapy
Immunotherapy uses the body's immune mechanism to fight tumor cells. There are many immunotherapies to fight cancer in research.
At present, cancer vaccine therapy and monoclonal antibody therapy are more advanced, and immune cell therapy is the latest treatment technology developed in recent years.
6. Traditional Chinese Medicine Treatment
Cooperating with surgery, radiotherapy and chemotherapy can alleviate the side effects of radiotherapy and chemotherapy, promote the recovery of patients, and enhance the tolerance to radiotherapy and chemotherapy.
7. Gene therapy
By introducing exogenous genes into the human body to correct gene defects, the concept of gene therapy for malignant tumors has been expanded from correcting gene defects to introducing exogenous genes into the human body, ultimately achieving direct or indirect inhibition or killing of tumor cells.
8. Endocrine therapy
The occurrence and growth of certain tumors are closely related to hormones in the body, so it can be treated by changing the endocrine status. For example, sex hormones can be used in the palliative treatment of breast cancer, prostate cancer, and endometrial cancer.
9. Hyperthermia treatment
The microwave hyperthermia technology, ultrasound focusing and radio frequency technology developed in the past 10 years use local high temperature to cause the cancer cells to be heated and necrotic, and less damage to normal tissues, which is simple and safe.
10. Laser treatment
Utilizing the advantages of high power density, good parallelism, and accurate positioning of the laser, a bloodless resection can be performed on the lesion after moderate focusing.
11. Cryotherapy
When freezing, ice crystals are formed inside and outside the cells, causing cancer cell damage. Can be used for body surface tumors or visceral tumors.
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