Cancer treatment---Integrated Medicine

1 Current major cancer therapies
1.1 surgical therapy
Prior to the nineteenth century, cancer generally was considered to be a systemic disorder; thus, remedies were systemic. An example of this tendency was that described by Galen of Pargamum (approximately 130–200 AD). Galen proposed that cancer was caused by an excess of “black bile” and recommended such remedies as bleeding, purging, and dietary restrictions. John Abernethy, an English surgeon and anatomist (1814), was one of the early investigators to consider that malignant tumors could be a local phenomenon and thus proposed the possibilities of treatment by surgical resection.
The role of surgeons in modern cancer management has continued to evolve from heroic and radical operations to remove extensive tumors to an integrated approach combining a variety of cancer treatment modalities: surgery, radiotherapy, and chemotherapy. Of course, the best opportunity for cure is sought while reducing associated morbidity and mortality. The real key to reducing mortality from cancer lies in prevention and early detection. Involved surgeons should be active participants in these and other cancer control efforts to reduce morbidity and mortality from cancer.
1.2 Radiotherapy
X-rays were first described in 1895 by Roentgen, and the Curies reported their discovery of radium approximately three years later. The biological effects of this ionizing radiation soon were realized, and they were used promptly to treat a variety of malignant and nonmalignant conditions. During the next decades, technologic advances accumulated rapidly.
Many advances in radiation oncology have occurred since the discovery of x-rays in 1895. Initially, radiation oncology was based largely on empiricism and clinical observations. Modern radiobiology provides a rationale for both normal-tissue and tumor response to irradiation. Researchers hope that future advances will continue to improve radiation
oncology and cancer care for all.
1.3 Systemic therapy
Medical oncology is a discipline that specializes in the use of systemic forms of treatment for the management of patients with malignancies. This focus of medical oncology on systemic therapy distinguishes it from surgical and radiation oncology, which are best suited for treating malignancies while they still are localized. The systemic treatment of malignancies began in the early 1940s when nitrogen mustard was first used to obtain a brief remission in a patient with lymphoma. This historic event demonstrated the potential of cytotoxic agents in the treatment of malignancies and ushered in the modern era of chemotherapy.
In 1948, Farber et al. demonstrated the activity of antifolate compounds in the treatment of leukemia. This finding was followed in 1949 by the synthesis of methotrexate (MTX), which proved to be the first drug capable of curing an advanced human malignancy (gestational choriocarcinoma). Improvements in therapy arose from the continued introduction of new cytotoxic drugs, and from the demonstration that combinations of cytotoxic drugs are often superior to single-agent therapy.
The superiority of combination chemotherapy to single-agent therapy was first demonstrated in the treatment of Hodgkin’s disease. Combination chemotherapy has subsequently proven successful in the treatment of childhood acute lymphocytic leukemia (ALL), testicular carcinoma, and intermediate and highgrade lymphomas.
Cytotoxic and hormonal agents are the current mainstay of systemic cancer treatment. Efforts continue in the search for new cytotoxic drugs, with the taxanes and topoisomerase I inhibitors being examples of recent successes in this field. Likewise, more selective hormonal agents also are being developed, primarily with the intent of reducing their effects on normal tissues.
2 High novel therapies
See informations about these in “Modern therapies”.
3 CAM therapies
CAM may be defined as “diagnosis, treatment and/or prevention which complements mainstream medicine by contributing to a common whole, by satisfying a demand not met by orthodoxy or by diversifying the conceptual frameworks of medicine.”
CAM, recommends that therapy instead address the entire body and employ a “non-toxic approach incorporating treatments that rely on biopharmaceutical, immune enhancement, metabolic, nutritional, and herbal, non-toxic methods.”The five categories:
(1) diet and nutrition;
(2) mind-body techniques;
(3) bioelectromagnetics;
(4) manual healing methods;
(5) herbal medicine.
(1) Diet and NutritionTypically, today’s proponents of dietary cancer treatments extrapolate the idea that food or vitamins can cure cancer from mainstream knowledge about the protective effects of fruits, vegetables, fiber, and avoidance of excessive dietary fat in reducing cancer risk. (2) Mind-Body Techniques
The potential to use our minds to influence our health is an extremely appealing concept in many countries. It affirms the power of the individual, a belief intrinsic to culture. Not surprisingly, then, mind-body medicine is extremely popular in many countries.
Some proponents argue that patients can use mental attributes and mind-body work to prevent or cure cancer. This belief is attractive because it ascribes to patients almost complete control over the course of their illness.
Attending to the psychological health of cancer patients is a fundamental component of good cancer care. Support groups, good doctor-patient relationships, and the emotional and instrumental help of family and friends are vital. However, the idea that patients can influence the course of their disease through mental or emotional work is not substantiated and can evoke feelings of guilt and inadequacy when disease continues to advance despite patients’ best spiritual or mental efforts.
(3) Bioelectromagnetics
Bioelectromagnetics is the study of interactions between living organisms and their electromagnetic fields. According to proponents, magnetic fields penetrate the body and heal damaged tissues, including cancers.
Cell culture studies demonstrated that electrochemical treatment inhibited cell proliferation and DNA synthesis. This preliminary effort was based on a technique widely used in China today to treat cancer in humans.
Decades ago, on the basis of a belief that a large magnet placed at the foot of a patient’s bed would pull cancer out of the body, magnets were sold as cancer cures. Today, simple magnets are sold to reduce pain. They can be purchased as arm, leg, or body bands, shoe inserts, or entire mattresses.
(4) manual healing methods
Manual healing includes a variety of touch and manipulation techniques. Osteopathic and chiropractic doctors were among the earliest groups to use manual methods. For its stress-reducing benefits, hands-on massage is a useful adjunctive technique for cancer patients and others.
(5) herbal medicine
Typically, herbal remedies are part of traditional and folk healing methods with long histories of use. Throughout history, some form of herbal medicine has been found is most areas of the world and across all cultures.
Cancer patients use over-the-counter herbal products in addition to or instead of those promoted specifically as cancer treatments. An important precaution is to differentiate between herbal remedies that may help cancer patients and those that are toxic or that interact with other medications.