- Ung thư là gì? Các phương pháp trị ung thư hiện nay.

Ưu nhược điểm: Hường

TLTK:
Risks of Cancer Surgery | American Cancer Society
Types of radiation therapy: How they work and what to expect (medicalnewstoday.com)
Targeted Therapy for Cancer - NCI
Treating Cancer with Immunotherapy | Types of Immunotherapy | American Cancer
Society
What Is Immunotherapy? | Immunotherapy for Cancer | American Cancer Society
1. What is cancer?
While one or more cells' genes are altered, cancer can start. DNA segments, often known
as genes (short for deoxyribonucleic acid), are found within every cell. Certain genes
instruct cells on how and when to proliferate and divide. However, if these genes are
harmed, the cells may develop cancer and cease to operate normally. Once cancer starts,
it can spread unchecked, overwhelming healthy cells and interfering with their ability to
function.
2. Types of Cancer Treatment
2.1 Chemotherapy
Chemotherapy is a common cancer treatment. It uses drugs to destroy cancer cells and
prevent tumor growth. It may be paired with other cancer treatments such as radiation
therapy or surgery. Chemotherapy is usually given intravenously (through a vein). It’s an
effective treatment but can cause side effects.
2.1.1How does chemotherapy work?
Cancer cells grow and divide uncontrollably. Chemotherapy destroys the cancer cells and
prevents them from multiplying.
● Adjuvant therapy: Chemotherapy destroys cancer cells after surgery or radiation
therapy.
● Curative therapy: Chemotherapy (which may also include radiation and/or
surgery) eliminates the cancer, and it doesn’t return.
● Neoadjuvant therapy: Chemotherapy shrinks a tumor before surgery or radiation
therapy.
● Palliative therapy: Chemotherapy shrinks tumors and lessens symptoms but
doesn’t cure the cancer.
2.1.2 What types of cancer can chemotherapy treat?
● Chemotherapy can treat a wide range of cancers, including:
● Primary cancer: Cancer that hasn’t spread to other areas of your body.
● Metastatic cancer: Cancer that’s spread to other areas of your body.
● The type of chemotherapy you receive depends on several factors:
 ● Location of the cancer.
● Stage of the cancer, or how advanced it is.
● Your overall health.
2.1.3 Risks / Benefits
2.1.3.1 Risks:
Chemotherapy drugs target all fast-growing cells, including cancer cells. This means
chemotherapy drugs destroy cancer cells but can also damage other cells in your body,
potentially causing side effects. Blood cells and the cells in your skin, hair follicles and
digestive tract are examples of cells that grow and multiply quickly. That’s why some
common side effects of chemotherapy occur in these areas, including:
● Anemia.
● Bleeding.
● Constipation.
● Diarrhea.
● Fatigue.
● Hair loss.
● Infection.
● Loss of appetite.
● Nausea and vomiting.
2.1.3.2 Benefits:
Despite the potential side effects, chemotherapy has been an effective, reliable cancer
treatment for decades. Chemo can rid your body of cancer completely, or it can help you
have a better quality of life by reducing symptoms.
2.2 Surgery to Treat Cancer
Surgery is used to treat many types of cancer. It works best for solid tumors that are
contained in one area. Surgery, when used to treat cancer, is a procedure in which a
surgeon removes cancer from your body.
2.2.1 How surgery is performed
● Cryosurgery
Cryosurgery is a type of treatment in which extreme cold produced by liquid nitrogen or
argon gas is used to destroy abnormal tissue. Cryosurgery may be used to treat early-
stage skin cancer, retinoblastoma, and precancerous growths on the skin and cervix.
Cryosurgery is also called cryotherapy.
● Lasers
This is a type of treatment in which powerful beams of light are used to cut through
tissue. Lasers can focus very accurately on tiny areas, so they can be used for precise
surgeries. Lasers can also be used to shrink or destroy tumors or growths that might turn
into cancer.
Lasers are most often used to treat tumors on the surface of the body or on the inside
lining of internal organs. Examples include basal cell carcinoma, cervical changes that
might turn into cancer, and cervical, vaginal, esophageal, and non-small cell lung cancer.
● Hyperthermia
Hyperthermia is a type of treatment in which small areas of body tissue are exposed to
high temperatures. The high heat can damage and kill cancer cells or make them more
sensitive to radiation and certain chemotherapy drugs. Radiofrequency ablation is one
type of hyperthermia that uses high-energy radio waves to generate heat. Hyperthermia is
not widely available and is being studied in clinical trials.
● Photodynamic Therapy
Photodynamic therapy is a type of treatment that uses drugs which react to a certain type
of light. When the tumor is exposed to this light, these drugs become active and kill
nearby cancer cells. Photodynamic therapy is used most often to treat or relieve
symptoms caused by skin cancer, mycosis fungoides, and non-small cell lung cancer.
2.2.2 Possible side effects of cancer surgery
Minor operations and taking tissue samples (biopsies) usually have less risk than a bigger
surgery. Pain at the surgery site is the most common problem. Infections at the site and
reactions to the drugs used to numb the area (local anesthesia) are also possible.
Some side effects are possible during and after surgery:
● Bleeding: Bleeding is part of any surgery and is usually controlled. Bleeding can
happen either inside the body (internally) or outside the body (externally).
Bleeding can occur if a blood vessel was not sealed off during surgery or if a
wound opens up.
● Blood clots: Blood clots can form in the deep veins of the legs after surgery,
especially if a person stays in bed for a long time. Such a clot can become a
serious problem if it breaks loose and travels to another part of the body, such as a
lung.
● Damage to nearby tissues: Internal organs and blood vessels can be damaged
during surgery.
● Drug reactions: Some people have reactions to the drugs used (anesthesia) or other
medicines needed during surgery.
● Damage to other organs: Surgery can lead to problems with other organs, such as
the lungs, heart, or kidneys. These problems are very rare but can be life-
threatening.
 ● Pain: Almost everyone has some pain after surgery. Pain is normal, but it should
not be allowed to slow down your recovery
● Infections and slow recovery of other body functions:
2.3 Radiation therapy
Radiation therapy is a type of cancer treatment that uses high energy beams to destroy
cancer cells and shrink tumors.
Radiation damages genetic material called DNA inside of cancer cells. If the cancer cell
cannot repair the DNA, the cell will not be able to produce new cells and may die.
2.3.1 Types of radiation therapy
There are two broad types of radiation therapy that doctors use to treat cancers: internal
and external.
● External beam radiation
External beam radiation is the most commonTrusted Source type of radiation treatment
for cancer.
External means that the energy beams come from a machine outside of the body. A
healthcare professional precisely aims the beams, which penetrate the body to reach the
cancer site.
Another name for external beam radiation is teletherapy.
● Internal radiation therapy
The second main type of radiation treatment is internal radiation therapy, also known as
brachytherapy.
During this treatment, a doctor places an implant containing radiation in or near the
cancer site.
2.3.2 Mechanism of action
External beam radiation and brachytherapy work similarly. Both are local therapies that
work on one part of the body, directing high energy beams at cancer cells to destroy
them.
However, the two therapies differ in the source of the radiation.
In brachytherapy, the radiation comes from an implant that a doctor places near or in a
tumor. In external beam radiation, the radiation comes from a machine outside of the
body.
2.3.3 Risks / Benefits
2.3.3.1 Benefits of Radiation Therapy

Radiation therapy offers a powerful tool against cancer with several advantages:
 ● Effective Cancer Cell Killer: Radiation directly damages cancer cells, stopping
their growth and division. In some cases, for small or early-stage cancers, radiation
alone can be curative.
● Versatility: Radiation therapy can be used in various ways:
○ As the primary treatment for some cancers.
○ Before surgery to shrink tumors and ease removal.
○ After surgery to eliminate any remaining cancer cells.
○ In combination with chemotherapy to enhance effectiveness.
○ For pain management and palliative care to reduce cancer-related
symptoms.
● Targets Specific Areas: Radiation can be precisely aimed at the tumor location,
minimizing damage to surrounding healthy tissues.

2.3.3.2 Risks of Radiation Therapy

While radiation offers significant benefits, it's not without potential risks:

● Damage to Healthy Tissue: Surrounding healthy cells can be affected by radiation

exposure, leading to side effects. The severity depends on the radiated area and
dosage. Common side effects include fatigue, skin irritation, hair loss in the treated
area, nausea, and mouth sores.
● Increased Risk of Other Cancers: Long-term exposure to radiation can slightly
elevate the risk of developing new cancers in the future.
● Effects on Fertility: Radiation therapy near reproductive organs can impact
fertility in both men and women.

2.4 Targeted Therapy to Treat Cancer

Targeted therapy is a type of cancer treatment that targets proteins that control how
cancer cells grow, divide, and spread. It is the foundation of precision medicine. As
researchers learn more about the DNA changes and proteins that drive cancer, they are
better able to design treatments that target these proteins.
2.4.1 Types of targeted therapy
Most targeted therapies are either small-molecule drugs or monoclonal antibodies.
● Small-molecule drugs are small enough to enter cells easily, so they are used for
targets that are inside cells.
● Monoclonal antibodies, also known as therapeutic antibodies, are proteins
produced in the lab. These proteins are designed to attach to specific targets found
on cancer cells. Some monoclonal antibodies mark cancer cells so that they will be
better seen and destroyed by the immune system. Other monoclonal antibodies
 directly stop cancer cells from growing or cause them to self-destruct. Still others
carry toxins to cancer cells.
2.4.2 Mechanism of action
Most types of targeted therapy help treat cancer by interfering with specific proteins that
help tumors grow and spread throughout the body. This is different from chemotherapy,
which often kills all cells that grow and divide quickly. The following explains the
different ways that targeted therapy treats cancer.
Help the immune system destroy cancer cells. One reason that cancer cells thrive is
because they can hide from your immune system. Certain targeted therapies can mark
cancer cells so it is easier for the immune system to find and destroy them. Other targeted
therapies help boost your immune system to work better against cancer.
Stop cancer cells from growing by interrupting signals that cause them to grow and
divide without order. Healthy cells in your body usually divide to make new cells only
when they receive strong signals to do so. These signals bind to proteins on the cell
surface, telling the cells to divide. This process helps new cells form only as your body
needs them. But, some cancer cells have changes in the proteins on their surface that tell
them to divide whether or not signals are present. Some targeted therapies interfere with
these proteins, preventing them from telling the cells to divide. This process helps slow
cancer’s uncontrolled growth.
Stop signals that help form blood vessels. To grow beyond a certain size, tumors need to
form new blood vessels in a process called angiogenesis. The tumor sends signals that
start angiogenesis. Some targeted therapies called angiogenesis inhibitors interfere with
these signals to prevent a blood supply from forming. Without a blood supply, tumors
stay small. Or, if a tumor already has a blood supply, these treatments can cause blood
vessels to die, which causes the tumor to shrink. Learn more about angiogenesis
inhibitors.
Deliver cell-killing substances to cancer cells. Some monoclonal antibodies are combined
with cell-killing substances such as toxins, chemotherapy drugs, or radiation. Once these
monoclonal antibodies attach to targets on the surface of cancer cells, the cells take up the
cell-killing substances, causing them to die. Cells that don’t have the target will not be
harmed.
Cause cancer cell death. Healthy cells die in an orderly manner when they become
damaged or are no longer needed. But, cancer cells have ways of avoiding this dying
process. Some targeted therapies can cause cancer cells to go through this process of cell
death, which is called apoptosis.
Starve cancer of hormones it needs to grow. Some breast and prostate cancers require
certain hormones to grow. Hormone therapies are a type of targeted therapy that can
work in two ways. Some hormone therapies prevent your body from making specific
hormones. Others prevent the hormones from acting on your cells, including cancer cells.
2.4.3 Risks / Benefits
2.4.3.1 Targeted therapy does have some drawbacks.
Cancer cells can become resistant to targeted therapy. Resistance can happen when the
target itself changes and the targeted therapy is not able to interact with it. Or it can
happen when cancer cells find new ways to grow that do not depend on the target.
Because of resistance, targeted therapy may work best when used with more than one
type of targeted therapy or with other cancer treatments, such as chemotherapy and
radiation.
Drugs for some targets are hard to develop. Reasons include the target’s structure, the
target’s function in the cell, or both.
2.4.3.2 What are the side effects of targeted therapy?
The most common side effects of targeted therapy include diarrhea and liver problems.
Other side effects might include
● problems with blood clotting and wound healing
● high blood pressure
● fatigue
● mouth sores
● nail changes
● the loss of hair color
● skin problems, which might include rash or dry skin
● Very rarely, a hole might form through the wall of the esophagus, stomach, small
intestine, large bowel, rectum, or gallbladder.
2.5 Immunotherapy
Immunotherapy is a biological cancer treatment that boosts the body’s immune system to
fight the cancer. Your body’s immune system works to detect something harmful,
producing antibodies and proteins that fight infection.
2.5.1 Types of cancer immunotherapy
There are several main types of immunotherapy used to treat cancer, and many are being
studied. For more information about immunotherapy as a treatment for a specific cancer,
please choose a cancer type.

● Checkpoint inhibitors: These drugs basically take the ‘brakes’ off the immune
system, which helps it recognize and attack cancer cells.
● Chimeric antigen receptor (CAR) T-cell therapy: This therapy takes some T-cells
from a patient's blood, mixes them with a special virus that makes the T-cells learn
how to attach to tumor cells, and then gives the cells back to the patient so they
can find, attach to, and kill the cancer.
 ● Cytokines: This treatment uses cytokines (small proteins that carry messages
between cells) to stimulate the immune cells to attack cancer.
● Immunomodulators: This group of drugs generally boosts parts of the immune
system to treat certain types of cancer.
● Cancer vaccines: Vaccines are substances put into the body to start an immune
response against certain diseases. We usually think of them as being given to
healthy people to help prevent infections. But some vaccines can help prevent or
treat cancer.
● Monoclonal antibodies (mAbs or MoAbs): These are man-made versions of
immune system proteins. mAbs can be very useful in treating cancer because they
can be designed to attack a very specific part of a cancer cell.
● Oncolytic viruses: This treatment uses viruses that have been modified in a lab to
infect and kill certain tumor cells.

2.5.2 What the immune system does

Your immune system is a collection of organs, special cells, and substances that help
protect you from infections and some other diseases. Immune cells and the substances
they make travel through your body to protect it from germs that cause infections. They
also help protect you from cancer in some ways.
The immune system keeps track of all of the substances normally found in the body. Any
new substance that the immune system doesn’t recognize raises an alarm, causing the
immune system to attack it. For example, germs contain substances such as certain
proteins that are not normally found in the human body. The immune system sees these
as “foreign” and attacks them. The immune response can destroy anything containing the
foreign substance, such as germs or cancer cells.
The immune system has a tougher time targeting cancer cells, though. This is because
cancer starts when normal, healthy cells become changed or altered and start to grow out
of control. Because cancer cells actually start in normal cells, the immune system doesn’t
always recognize them as foreign.
Clearly there are limits on the immune system’s ability to fight cancer on its own,
because many people with healthy immune systems still develop cancer:
Sometimes the immune system doesn’t see the cancer cells as foreign because the cells
aren’t different enough from normal cells.
Sometimes the immune system recognizes the cancer cells, but the response might not be
strong enough to destroy the cancer.
Cancer cells themselves can also give off substances that keep the immune system from
finding and attacking them.
2.5.3 Risks / Benefits
Benefits of Immunotherapy:
 ● Targeted Attack: Immunotherapy can target specific features of cancer cells,
potentially leading to more precise treatment compared to traditional therapies that
might harm healthy cells.
● Long-lasting Effects: Immunotherapy can sometimes trigger durable responses,
where the immune system keeps fighting cancer cells even after treatment stops.
● Fewer Side Effects: Compared to chemotherapy and radiation, immunotherapy can
cause less severe side effects for some patients.

Risks of Immunotherapy:

● Overactive Immune System: Immunotherapy can sometimes overstimulate the

immune system, leading to autoimmune reactions. These reactions can affect
healthy organs like the skin, lungs, bowels, or endocrine glands, causing
inflammation and tissue damage.
● Unpredictable Responses: Immunotherapy can have variable effectiveness. Not all
patients respond to treatment, and the reasons for this are still being researched.
● High Cost: Immunotherapy treatments can be expensive compared to other cancer
therapies.