Types of Treatments for Cancer

The goal of cancer treatment is to put you in remission or control the spread of your cancer. Your treatment plan will depend on the type of cancer you have, the stage of your cancer, your overall health, and your personal choices.

Some people with cancer will undergo many different types of treatment; others may have just one.

Your healthcare team will help you decide which options are best for your particular condition.

The Most Common Cancer Treatments

Generally, three main types of therapies are used for cancer. These options are sometimes given together, or they may be used separately. They include:

Surgery

About 60 percent of cancer patients will undergo some type of surgery as part of their treatment. (1)

Surgery often involves cutting out and removing the cancer from your body. Typically, surgery is a good option for cancers that aren’t advanced and haven’t spread to other areas of the body. There are many types of surgical approaches, depending on the type of cancer you have.

Chemotherapy

Chemotherapy uses powerful drugs to kill cancer. This therapy is often used to treat cancers that have spread throughout your body because the medicines travel through the bloodstream. Most of the time, more than one chemotherapy drug is used at the same time. The medicines you receive will depend on the type of cancer you have. Chemo can be given as an intravenous (IV) infusion, an oral pill, an injection, or through pumps and tubes into specific areas of the body. Side effects depend on the type of chemotherapy you receive and may include nausea, vomiting, hair loss, fatigue, infections, and weakness.

Radiation

More than half of all cancer patients will receive radiation therapy at some point. (2) It works by using radiation to destroy or damage cancer cells in your body. Most of the time, radiation works best at treating cancers that are contained in one area. This is because, unlike chemotherapy, radiation therapy is a local treatment, meaning it targets the area where the cancer originated, to sterilize that specific area of cancer cells. Side effects might include skin changes or burns, feeling tired, or loss of appetite. There are two main kinds of radiation:

• External Beam Radiation This type involves using a machine that aims radiation at your cancer from outside the body.
• Internal Radiation With internal radiation, seeds, ribbons, capsules, or liquids that contain a source of radiation are placed inside your body to kill cancer cells. This form of radiation is used primarily for prostate and cervical cancers or for tumors in the liver.

Newer Treatments Attack Cancer Cells More Precisely

Other therapies that are used to treat cancer include:

Immunotherapy

Your immune system is a collection of organs, cells, and substances that react to infectious organisms. It can also help protect against cancer.

Immunotherapy uses your body’s own immune system to fight cancer. Some types of immunotherapy are called biologic treatments.

Essentially, immunotherapy works by prompting your body’s immune system to work harder to attack cancer cells. Or the treatment may involve delivering immune system proteins to help destroy cancer. (3)

Side effects of immunotherapy vary from patient to patient and may include skin reactions, flu-like symptoms, swelling, weight gain, diarrhea, sinus congestion, or heart palpitations.

Immunotherapy can be given topically, orally, or intravenously, depending on the treatment. (4)

Some types of immunotherapy include:

Vaccines Vaccines work by boosting your immune system’s response to cancer cells. Researchers are working on vaccines that target cancer, and there are also vaccines aimed at viruses that predispose you to cancer. One example is the human papillomavirus (HPV) vaccine, which is highly effective against HPV, the most common sexually transmitted disease in the United States — and a known cause of cervical, penile, anal, and throat cancer.

Monoclonal Antibodies Some monoclonal antibodies are a type of immunotherapy, while others work like targeted treatments. Monoclonal antibodies that impact the immune system mark cancer cells or cause an immune response that destroys cancer. ( 5)

Immune Checkpoint Inhibitors These drugs, which are considered a type of monoclonal antibody, block checkpoint molecules, including CTLA-4, PD-1, and PD-L1. In doing so, they help release the “brakes” on the immune system, so T cells (special white blood cells) can seek out and destroy cancer cells. Immune checkpoint inhibitors are used for different types of cancer, including melanoma, lung cancer, kidney cancer, head and neck cancer, bladder cancer, breast cancer, liver cancer, and Hodgkin lymphoma. (6)

Adoptive Cell Transfer This treatment boosts the ability of your T cells to fight cancer. Typically, doctors take T cells from a tumor or the blood, isolate or modify the cells, grow them in a lab, and inject them back into your body.

CAR T cell therapy is a type of adoptive cell transfer. CAR T cells are cells that have been taken from a patient’s blood and “trained” in the lab to seek out and kill tumor cells. The treatment has been used with success on blood cancers and is now being studied on other types of cancer. (7)

Oncolytic Virus Therapy This treatment uses genetically modified viruses to kill cancer cells. Doctors inject a virus into a person’s tumor. Then the virus enters the cancer cells and makes copies of itself, causing the cells to die. When this happens, the cells release antigens, which trigger a person’s immune system to target other cancer cells in the body. The first oncolytic virus therapy was approved for melanoma in 2015, and scientists are studying the technique for other types of cancer. (8)

Other, Nonspecific Immunotherapy Drugs These treatments don’t target specific cancer cells but instead stimulate the immune system in a more general way. Some examples include:

• Cytokines These proteins, which are made by your body’s cells, are sometimes used to help your immune system target cancer. Interferons and interleukins are two types of cytokines that are given to treat cancer.
• BCG This type of immunotherapy, which stands for Bacillus Calmette-Guérin, is used to treat bladder cancer and is being studied for other cancers.
• Immunomodulating Drugs These medicines are thought to work in a general way by boosting the immune system. They’re used to treat multiple myeloma and other cancers.
• Imiquimod This medicine, which is applied to the skin, rouses a local immune response against skin cancer cells. (9)

Targeted Treatments

Targeted therapies aim for specific gene abnormalities that cause cancer cells to thrive. The treatments specifically zero in on changes in cancer cells that help them divide, grow, and spread. Side effects of targeted therapies include diarrhea, liver problems, issues with wound healing, high blood pressure, mouth sores, fatigue, nail changes, and skin problems. There are two main types of targeted therapies:

• Small-Molecule Drugs These medicines are small enough to enter cells easily, so they can target inside the cells. Small-molecule drugs are typically given orally.
• Monoclonal Antibodies These drugs attach to specific targets on the outer surface of cancer cells. Some monoclonal antibodies are considered both immunotherapy and targeted treatments. They’re usually delivered into a vein through a needle.

Stem Cell Transplants

A stem cell transplant, also known as a bone marrow transplant, can restore blood-forming stem cells in people who have very high doses of chemo or radiation. The transplant involves delivering healthy, blood-forming stem cells through a needle into your vein. The stem cells can come from a donor or your own body, depending on the type of cancer you have. These transplants allow you to receive higher doses of chemo or radiation. They’re commonly used in people with leukemia or lymphoma.

Hormone Therapy

Hormone therapy can slow or stop cancer that relies on hormones to grow. It’s sometimes called hormone treatment or endocrine therapy. Hormone therapy is often used in men with prostate cancer and women with breast cancer. Side effects can include hot flashes, fatigue, diarrhea, nausea, loss of interest in sex, mood changes, vaginal dryness, menstrual changes, and enlarged breasts (in men).

Alternative and Complementary Approaches

Some people with cancer opt to include alternative and complementary therapies in their course of treatment. The term “alternative medicine” is typically used to describe treatments that are given instead of standard medical care. “Complementary medicine” usually describes therapies that are used along with your regular medical treatments.

Complementary approaches may help relieve unpleasant side effects of cancer treatments, such as pain, nausea, fatigue, and weakness.

The American Cancer Society warns that you should use caution when considering an alternative treatment. Look for red flags, such as claims that a certain product can cure your disease.

Some alternative treatments haven’t been proven to be safe or effective. Delaying or foregoing standard medical care can allow cancer to grow more aggressively. Be sure to talk with your doctor before starting any type of alternative or complementary therapy.

Types of Alternative and Complementary Therapies

Some common alternative and complementary therapies used in cancer include:

• Acupuncture This ancient Chinese practice, which involves inserting tiny needles into certain points of the body, is sometimes used to help with pain, nausea, or vomiting in people with cancer.
• Supplements Some people who have cancer use dietary supplements. These might include vitamins C and E, licorice root, fish oil, milk thistle, asparagus root, astragalus, flaxseed, turmeric, coenzyme Q10, and others. Many supplements can affect how cancer treatments work in your body, so be sure to talk to your doctor before taking anything new.
• Massage Massage might help reduce pain, anxiety, stress, and fatigue in people with cancer. Some massage therapists are specially trained to work on cancer patients.
• Yoga Yoga combines deep breathing with stretching exercises. It’s sometimes used to improve sleep and reduce fatigue in people with cancer.
• Meditation Meditation may help people with cancer relieve stress and anxiety. It involves focusing on an image, thought, or idea while you’re in a deep state of concentration.
• Hypnosis Hypnosis involves putting someone in a deep state of concentration. Some people with cancer use it to improve their thoughts, control pain, and reduce stress.
• Aromatherapy Breathing in essential oils from plants may help with stress and anxiety. Some common oils include peppermint, frankincense, lavender, and rosemary.
• Exercise Physical activity can give you more energy and help you feel better. Some studies even show exercising may help people with cancer live longer and improve their overall health.
• Medical Marijuana Medical marijuana is sometimes used to help with nausea, pain, vomiting, and loss of appetite in people with cancer. There is no good evidence that this works better than the medication your doctor can offer, and the strength of marijuana is highly variable. This treatment isn’t legal in every state, so you’ll have to check your options.

Are Cancer Cells Immortal?

One of the most challenging parts of treating cancer is understanding how cancer cells live and grow.

Normal cells in your body die off, but cancer cells can grow forever if they’re not stopped. Scientists believe cancers become “immortal” by ridding themselves of normal brakes on growth and by evading normal aging that occurs to cell DNA after a certain number of cell divisions.

Research studies aimed at stopping the endless life span of cancer cells are underway. (10)

The Future of Cancer Treatment Is Promising

Researchers are working to figure out ways to improve cancer treatment and increase survival in patients. Personalized medicine and gene therapy are two areas of focus that hold promise for the future of cancer care.

Clinical trials allow scientists to test new cancer treatments that could become standard care. Some people with cancer choose to participate in these studies to receive cutting-edge treatments that they wouldn’t get otherwise.

You can learn more about clinical trials for cancer by visiting the National Cancer Institute’s website.