• Curative: Removes all cancer tissue. May cure if all affected tissue is removed. Most effective for small localized tumors or noninvasive skin cancers. • Cancer control (cytoreductive): Removes part of the tumor when entire mass is not possible. Also known as “debulking” surgery. Decreases the size of the tumor and the number of cancer cells, which alleviates symptoms and enhances the success of other types of cancer treatment, as well as increase survival time. • Palliative: Provides symptom relief, improves quality of life, not curative. Examples: Tumor tissue removal causing pain, obstruction, or difficulty swallowing, and the treatment of neuropathic pain from bone metastasis • Reconstructive (Rehabilitative): Increases function, enhances appearance, or both. Examples: breast reconstruction after mastectomy, reconstruction of the esophagus after surgical removal for esophageal cancer, bowel reconstruction, revision of scars, and cosmetic reconstruction in head and neck cancer. Surgery often plays a part in the diagnosis and/or management of cancer. Typically surgery is only one part of a comprehensive treatment approach for cancer therapy. It is used for prophylaxis, diagnosis, cure, control, palliation, assessment of therapy effectiveness, and tissue reconstruction.
CONSIDERATIONS FOR SURGICAL THERAPY Often involves the loss of a body part or its function Whole organ removal (kidney, lung, breast, testis, limb, or tongue) Organ loss reduces function. Scarring or disfigurement, may cause profound changes in appearance or activity level leading to depression, grief, and decreased enjoyment of life Often patients express the desire to have all cancerous tissue removed, which is not usually possible. Patients may not understand that cancer cells often escape from the original tumor, making cancer a systemic disease Overall care needs are similar to the care required for patients who undergo other surgeries For cancer surgery, additional priority care needs are psychosocial support and helping the patient achieve maximum functioning Physical rehabilitation to improve physical functioning may be indicated after cancer surgery (exercises, OT, PT)
RADIATION THERAPY Radiotherapy uses high-energy radiation from gamma rays, radionuclides, or ionizing radiation beams to kill cancer cells, provide disease control, or relieve symptoms. The delivery of radiation should accomplish these actions with minimal damaging effects on the surrounding normal cells. Can be delivered by external beam (teletherapy) or internal devices (brachytherapy).
PLANNING/ IMPLEMENTING RADIOTHERAPY External Radiation Therapy: • Local treatment; high energy rays to the tumor via a linear accelerator • Kill or reduce tumor size, relieve obstruction or decrease tumor size • May be given before chemo to shrink the tumor • Area marked or “tattooed” semi- permanent; • Tx 15 – 30 minutes 5 days a week for 2-7 weeks • Kills normal cells as well • Effects rapidly dividing cells • Video of radiation to the prostate: tZoXsytBN70 Pt is not radioactive, there is no danger to others!
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