Treatment of Cancer

• Hyperthermia. The use of heat to damage and eradicate cancer cells without damaging normal cells. Heat is applied from outside the body using a machine or directly to the tumour using a needle or probe.
• Laser therapy. This technique employs a very narrow and focused beam of light to destroy the cancer cells. It is applied by means of a fine, lighted tube that is inserted in the body or placed directly over the skin. Laser therapy is used to: destroy tumours and precancerous tumours, reduce tumours, help treat symptoms such as bleeding, reduce postoperative pain by sealing nerve endings, seal lymph vessels, and prevent tumour cells from propagating.
• Photodynamic therapy. In this type of therapy, the patient is injected with a medication that is sensitive to a special type of light. The medicine remains in cancer cells for longer than in healthy cells. A doctor then focuses the light from a laser or other source on the cancer cells. The light transforms the medicine into a substance that destroys cancer cells.
• Cryotherapy. This type of treatment employs an extremely cold gas to freeze and eliminate the cancer cells. It is sometimes used to treat cells that could develop into a malignant tumour (precancerous cells) on the skin or cervix, for example. Doctors may also use a special instrument to apply cryotherapy to tumours inside the body such as liver or prostate tumours.

A clinical trial is a medical research study carried out on people that decide to participate voluntarily. They contribute to the discovery of better methods of treating, preventing, diagnosing and understanding human diseases such as cancer. Clinical trials may be used to test the safety and efficacy of new medications or to compare existing treatments in order to determine which is more beneficial.

Many clinical trials compare a new treatment against the best treatment currently available (which is usually given to what is known as the control group). If no effective treatment has been developed yet, the new therapy can be compared against a placebo, that is, a preparation that looks like a medicinal product, but which does not have any activity. To ensure the results are reliable patients may be randomly assigned to one of the treatment groups (randomisation) and neither the patient nor the doctor knows which of the two treatments they will receive (unless they need to know this information).

Before conducting trials with human subjects, safety and efficacy studies are performed on animals and if the therapy is considered promising and safe, the research will continue and proceed to the study carried out with people, but while always taking all possible precautions.

All clinical trials are regulated by a protocol which defines the study plan, in other words, how it will be conducted and why it should be conducted, the participant inclusion criteria, which participants will be excluded to avoid detriment against them, and so on.

This study protocol must be reviewed and approved by a group of hospital experts and the health authorities before the trial can begin. These experts are responsible for protecting the rights of the people who will participate in the trial.

In Spain, new medicinal products cannot be registered or marketed without firstly undergoing clinical trials that demonstrate their safety and efficacy under specific conditions. Therefore, clinical research is both necessary and desirable.

The importance of clinical trials for the advancement of medicine is unquestionable. If they were not conducted, and without the volunteers who selflessly participate in them, researchers would not be able to discover effective treatments for human diseases.

The treatments can produce side effects that depend on the location of the tumour, the type of treatment and each person’s sensitivity. Most of the late side effects associated with both chemotherapy and radiotherapy disappear at the end of the treatment. But some persist, reappear or develop later on. These late effects may include the appearance of a second cancer. However, the risk of a second cancer emerging due to chemotherapy or radiotherapy is very low and inferior to the benefit obtained by treating the cancer.

Some cancer patients turn to treatments that are not considered part of conventional clinical practice, whether as a complement to the therapies indicated by their doctors (complementary medicine) or as a substitute (alternative medicine). There are several reasons why patients resort to these treatments: partially controlled symptoms, a patient response to the disease’s progression and anxiety, amongst others.

The lack of evidence regarding these treatments makes it impossible to define the possible indications. Some helpful criteria for patients who decide to use them are as follows:

• The key point when making decisions is safety. Natural does not mean the therapy is without risks.
• Do not confuse well-being with treatment efficacy. There are procedures or situations that improve patient well-being but without interfering with the treatment. Well-being is a very subjective sensation, so it is difficult to extrapolate the possible benefits to other patients.
• It is essential to discuss the options with the professionals. The doctors prescribing the oncological treatments must be told about the exact drugs or natural products taken by each patient.
• Herbal treatments (phytotherapy) can have pharmacological interactions with conventional treatments.
• Most public health systems do not provide financial support for complementary (or alternative) treatments given the lack of solid evidence concerning their efficacy. Resorting to complementary (or alternative) therapies can represent a significant cost for the patient.
• The reliability of the sources of information is very important. The following criteria should be considered:
  • Who has produced the information? Government sources or educational institutions (.gov, .edu).
  • Who sponsors the studies and how are they financed?
  • How are the results disseminated? Is it in peer-reviewed publications?
  • The date when the information was produced is a very important factor as the field of oncology is subject to very rapid changes and innovations.
• A lot of information about the benefits of certain treatments is spread through social networks. In such cases it is very hard to assess the reliability. It is important to remember that as a general rule the benefits derived in a specific person cannot be automatically extrapolated to other people.