Types of Cancers and Cancer Treatments
Cancer is a broad term for a group of disorders, describing an abnormal cell growth, and encompasses a number of malignant diseases. Cancer cells multiply quickly,have different shapes from the healthy cells, and can spread throughout the body. The clusters of such cells (tumors)can grow uncontrollably. Tumors аrе divided into two categories – benign (non-cancerous) or malignant (cancerous). The first ones grow slowly and do not spread. The malignant tumors grow fast, easily invading and destroying the nearby tissues. Later they enter the bloodstream or lymphatic system, spreading quickly throughout the body (metastasis). There is a wide range of different cancer types, which can originally affect specific parts of the body. When cancer has spread and affected areas of the body, or organs, which were healthy, the name of the cancer type is referred to the organ or the part of origination. The original tumor is the “primary tumor”, the new tumors in other body parts, are the “secondary.” Some cancer types could be of a mixed origin and type.
- Types of Cancers
- Bile Duct Cancer
- Bowel, Colon, and Rectum Cancers
- Pancreatic Cancer
- Bone Cancer
- Breast – Primary and Secondary
- Childhood Cancers
- Cancer of the Eye
- Esophageal Cancer
- Head and Neck
- Kaposis Sarcoma
- Lung Cancer
- Lymphoma Non-Hodgkins
- Womb – Uterus
- Skin Cancers
- Thyroid Cancer Thyroid
- Cancer Treatments
Bile Duct Cancer
Bile duct cancer occurs rarely, and could happen inside the liver or in the part of the bile duct (tubes) that is outside liver,and connects it to the gallbladder, and small intestine. The cancer type in which cancer cells form in the ducts that are outside the liver (extrahepatic) is more common. Among the most important risk factors are inflammation of the bile duct, aging,liver diseases, and exposure to some chemicals. Some of the symptoms are: jaundice, itchy skin, fever, abdominal pain, weight loss.
Bowel, Colon, and Rectum Cancers
Gastrointestinal cancers encompass cancers that affect everything in the area from the esophagus to the anus. The colon and rectum are part of the large intestine. Bowel cancer (also called colorectal cancer) is considered a serious disease, but its development takes many years, and if diagnosed early, is often curable. It affects predominantly people over 50 years of age, but it can also happen in younger people.With aging, little polyps may start growing inside the colon or rectum. Later they can become cancerous. This cancer type usually begins in the lining of the colon / rectum, but if untreated, it penetrates deeper into the wall of the bowel, and can then spread to lymph nodes, and from here – to the liver or lungs.
Since it doe snot cause symptoms at the beginning of its development, pancreatic cancer is hard to catch early, making it difficult to treat this type of cancer later, when it spreads quickly. Some of the symptoms are: skin and eyes yellowing, pain in the abdomen and back, weight loss and fatigue. Nearly all of the pancreatic tumors are called adenocarcinomas, meaning a cancer starting in gland cells. The ampullary cancer causes early signs such as yellowing of the skin and eyes, helping to be found at an earlier stage and treated successfully. The tumors of the endocrine pancreas, known as islet cell tumors or neuroendocrine tumors, are less common.
Bone cancer is a rare type of cancer, affecting primarily children. Benign bone tumors are much more common. Primary cancer types, which start in the bones are uncommon, while those that has spread to the bone from other parts of the body (secondary)are more widespread.
There three main common types of primary bone cancer:
- Osteosarcoma – arises from osteoid tissue in the bone , and occurs mostoften in the knee and upper arm (Wittig et al., 2002). Most vulnerable are children between ages 10 and 19.
- Chondrosarcoma – begins in cartilage, usually after age 40. This cancer type occurs most often in the pelvis, between the hip bones, upper leg, and shoulder.
- Ewing Sarcoma Tumors – occur in bone, most often in children and teens under 19, but may also arise in soft tissue (muscle, fat, or other tissues). This type of cancer is found most commonly along the backbone and pelvis, and in the legs and arms.
The main types of primary brain tumors among adults are:
- Astrocytoma: The tumor starts its formation from the star-shaped glial cells called astrocytes, most often in the part of the brain called the cerebrum. In somecases the tumor may be called aglioblastoma or malignant astrocytic glioma.
- Meningioma: That tumor type arises in the meninges, usually benign and grows slowly.
- Oligodendroglioma: The tumor develops in the cerebrum part of brain, from the cells of the fatty substance covering nerves. This cancer type is common in middle-aged adults. Several of the brain cancer types are common in children (e.g. medulloblastoma, juvenile pilocytic astrocytoma, ependymoma).Other types are stem glioma and hypothalamic glioma
Breast – Primary and Secondary
Breast cancer affects a large part of women worldwide, and causes the death of about 200 000 women per year, only in the United States. The most common types of breast cancer are the ductal carcinoma and the lobular carcinoma, or a mixture of both. In the paget disease of the nipple the abnormal cells are in the nipple only.
In its later stages, the breast cancer could be spread to the chest wall and/or to the skin of the breast, and to the lymph nodes near the breastbone and collarbone (Jatoi and Proschan, 2005). In inflammatory breast cancer the cancer cells block the lymph vessels in the skin, causing inflammation.
Later the cancer is spread to other organs, most often the bones, lungs, liver, or brain. According to the American Cancer Society (2009) secondary breast cancer is associated with high-dose radiation therapy to the chest for women treated between 10 and 30 years of age, such as for Hodgkin lymphoma. Breast cancer incidence rates among women with such exposure start to rise several years after radiation treatment and could continue to be elevated for more than 25 years.
Carcinoid tumors are rare, slow-growing cancers,which start in the lining of the digestive tract, or in the lungs. They do not produce symptoms in the early stages, and the average age of people with digestive or lung carcinoids is about 60. In their later stages the tumors could begin producing hormones, causing carcinoid syndrome. Carcinoid is a type of neuroendocrine tumor originating in the cells of the neuroendocrine system, but metastasis can occur.
Some of the cancer types that occur most often in children are different from those in adults. Unlike most of the cancers in adults, childhood cancers are not tightly related to lifestyle or environmental risk factors. Childhood cancers occur suddenly, without warning symptoms, and usually have a high rate of cure.
The most common for children’s cancer types are leukemia (Childhood Leukemia, particularly – acute lymphocytic leukemia), brain tumors, lymphoma, bone cancers, and soft tissue sarcoma. Hepatoblastomais a rare kind of liver cancer that develops in children younger than 4 years.
Among children, the most common brain cancer types are: Medulloblastoma, Juvenile pilocytic astrocytoma. Ependymoma is another cancer type, most commonly found in children and young adults, in which the tumor arises from cells that line the ventricles or the central canal of the spinal cord. Brain stem glioma -the tumor occurs in the lowest part of the brain. The most common type is diffuse intrinsic pontine glioma . Some kidney tumors are also specific for the childhood age, like the Wilms’ Tumor and others. In children, the two types of eye cancer are: retinoblastoma – a cancer of the retina, and medulloepithelioma.
Cancer of the Eye
Cancers of the eye are rare, and are grouped into two main types intraocular cancers. Intraocular Melanoma is the most common primary cancer in adults, followed by intraocular lymphoma. The most common eye cancer in children is retinoblastoma, which begins in the retina cells.Secondary intraocular cancers are more common and are spread to the eye from other organs. The most common cancers that spread to the eye,particularly to the part of the eyeball called the uvea, are breast and lung cancers. Although it is rare, intraocular melanoma is a common type of cancer in the uvea of the eye in adults. Intraocular melanomas can also start in the iris.Cancers can be found in the orbit and adnexa, developing in the tissues around the eyeball.
Squamous cell carcinoma –a type of cancer starting in squamous cells is called squamous cells, and occurring anywhere along the esophagus.
Adenocarcinoma – the cancer starts in the gland cells in the lower
esophagus, which are not normally part of the inner lining of the esophagus. Usually before an adenocarcinoma develops, gland cells replace some of squamous cells, which happens in Barrett’s esophagus.
Other esophagus cancer types can also develop(lymphomas, melanomas, and sarcomas).
Head and Neck
Most head and neck cancers develop in the moist mucosal tissues of the head and neck, such as the mouth, throat, salivary glands and nose, as well asthe lymph nodes in the neck. The major types cancers in the area are: Hypopharyngeal, Laryngeal, Lip and Oral Cancer, Metastatic Squamous Neck Cancer, Nasopharyngeal and Oropharyngeal Cancer, Paranasal Sinus and Nasal Cavity Cancer. The cancers in the upper aerodigestive tract are the most common, and affect the lips, tongue, mouth, throat, and voice box (larynx). Almost all cancers in this part of the head are squamous cell carcinomas, which can also occur on the skin of the head and neck. Salivary gland cancer is rare.
Kaposi’s sarcoma malignant tumors form abnormal tissue growth (lesions)often under the skin, in the lining, the mucous membranes of the mouth, nose, and throat, but also in lymph nodes and other organs. A characteristic of this cancer type is that lesions may begin simultaneously in several places in the body.
There is evidence that Human herpesvirus-8 (HHV-8) is related to Kaposi sarcoma development. Patients with immune systems weakened by disease or by drugs given after an organ transplantation, and infected with HHV-8are at a higher risk.There are several types of Kaposi sarcoma, includingClassic Kaposi sarcoma, African Kaposi sarcoma, Immunosuppressive therapy–related Kaposi sarcoma, Epidemic Kaposi sarcoma and Non-epidemic Kaposi sarcoma
Renal cell cancer (renal cell carcinoma) is the most common type of kidney cancer. Sometimes there could be two or more tumors growing in one kidney or even tumors in both kidneys at the same time. The most widespread subtypes of this cancer are: Clear cell renal cell carcinoma and Papillary renal cell carcinoma. They are also called chromophilic. The Chromophobe renal cell carcinoma, Collecting duct RCC, Multilocular cystic RCC, and Medullary carcinoma, Mucinous tubular and spindle cell carcinoma, Neuroblastoma-associated RCC, are rare renal cancer types and subtypes. Other kidney cancers are transitional cell carcinomas, Wilms tumors (in children), and renal sarcomas.
Leukemia is a blood cancer of the bone marrow, preventing the production of normal red and white blood cells, and platelets. There are 4 major types of leukemia, depending on the cells they begin from and processes speed:
- Acute myeloid (or myelogenous) leukemia (AML)
- Chronic myeloid (or myelogenous) leukemia (CML)
- Acute lymphocytic (or lymphoblastic) leukemia (ALL)
- Chronic lymphocytic leukemia (CLL)
Acute leukemia progresses rapidly, spreading to other parts of the body – lymph nodes, liver, spleen, brain, etc. Acute Lymphocytic Leukemia, starts from immature forms of lymphocytes in the bone marrow, where blood cells are produced. Acute Myeloid Leukemia starts in the myeloid cells, that make white blood cells (other than lymphocytes), red blood cells, or platelet-making cells. Chronic leukemia develops more slowly, and have two main types – Chronic lymphocytic leukemia, and Chronic myeloid leukemia.
Hemangioma, hepatic adenoma, and focal nodular hyperplasia are benign liver tumors, some of which could develop into liver cancer. There are several major primary liver cancer types. Hepatocellular carcinoma (hepatocellular cancer, hepatoma) is the most common type of liver cancer in adults. Another type cancer of the liver is the intrahepatic cholangiocarcinoma. Angiosarcoma and hemangiosarcomaare rare liver cancers. Secondary liver tumors can spread from other parts, such as the pancreas, colon, stomach, breast, or lung.
Lung cancers begin in the cells lining the bronchi and parts of the lung. Later lung cancer cells can enter lymphatic vessels and start to grow in lymph nodes around the bronchi, and in the area between the lungs. From lymph nodes, cancer cells are spread to other organs. Non-Small Cell Lung Canceris the most widespread with over 85% of all lung cancers. Squamous cell carcinoma, adenocarcinoma, and large cell carcinoma are subtypes of this cancer type.Squamous cell carcinoma in the inside lining of lungs airways, in the middle of the lungs, while adenocarcinoma develops in lung outer parts. Large cell carcinoma can appear in any part of the lung. Some of the rare subtypes of non-small cell lung cancer are adenosquamous carcinoma, sarcomatoid carcinoma. Small Cell Lung Cancer tends to spread quickly, whereas Lung Carcinoid Tumor is slow-growing. Rare types are: adenoid cystic carcinomas, lymphomas, and sarcomas.
Lymphoma can develop and spread anywhere due to the large lymph tissue network throughout the body. The two major types of lymphoma are Hodgkin lymphoma and non-Hodgkin lymphoma. Hodgkin disease is common to people in their late 20s or over 50, and affects the lymph tissue anywhere in the body, and spreading to other organs. Most lymphoma cases are non-Hodgkin lymphoma types. Age is one of the major factors influencing the type of non-Hodgkin lymphoma – slow developing lymphomas are more common in older people, whereas the fast growing non-Hodgkin lymphomas most often affect children and young adults. This type of lymphoma has become more common,due to the increased number of people with a suppressed immune system (infected with HIV, or after an organ transplant).
Malignant mesothelioma is a tumor in the pleura – the layer of the tissue lining the chest cavity and covering the lungs, or in the peritoneum, lining the abdomen and covering most of the organs inside, or elsewhere. This cancer type often starts in the lungs, but can also develop in the abdomen or other organs. Malignant mesothelioma rare, but a serious cancer type. Asbestos particles exposition is widely accepted as the major cause for the disease.
Most blood cells start their development from the stem cells in bone marrow.Stem cells mature into different types of blood cells (white, red,and platelets) with specific functions. Myeloma begins with an abnormal growth in plasma cells. Over time, these (myeloma) cells collect in the bone marrow and may damage the solid part of the bone. When the myeloma cells are in one bone and develop a single tumor, it is a plasmacytoma. After myeloma cells have gathered in several bones, forming many tumors, the name is “multiple myeloma.” Itis dangerous not only for the bones, but also for other tissues and organs.
Ovarian cancer is rare, but is the leading cause of death from cancer of the female reproductive system. Ovarian cancers are either ovarian epithelial carcinomas, beginning in the cells covering the outer ovary surface, or malignant germ cell tumors – starting in egg cells. Stromal tumors start from the structural ovary tissue cells. A large part of all ovarian cancers are malignant epithelial ovarian carcinomas, life-threatening types, which can metastasize to other parts of the body. The serous type is the most common, but there are also other types (mucinous, endometrioid, and clear cell, etc.). At first, epithelial cancers spread to the lining and organs of the pelvis and abdomen, but later they spread to other organs. Most germ cell tumors are benign, but some are cancerous. Teratomas may also be in a cancerous form (immature teratoma). Rare ovary cancers are: Primary peritoneal carcinoma, Fallopian tube cancer, Dysgerminoma, Endodermal sinus tumor, etc.
Vulvar cancer is not a common type of cancer,the squamous cell vulvar carcinoma being the most common followed by the melanoma of the vulva. Other much less common types include Paget’s Disease of the vulva, vulvar adenocarcinoma, sarcoma, and basal cell carcinoma. Women with a condition called vulvar intraepithelial neoplasia are at a higher risk of developing vulvar cancer.
Vaginal canceris a rare type of cancer, more common in women after the age of 60. The human papillomavirus (HPV) infection also increases the risk of this cancer. Squamous cell carcinoma is the most common type of vaginal cancer that develops in the squamous cells of vagina lining. This cancer spreads slowly and usually keeps its initial position near the vagina, but in some cases may spread to the lungs, liver, or bone. Adenocarcinoma starts in the glandular cells, and is more likely to spread to other parts, such as the lungs, and lymph nodes.
Womb – Uterus
There are two main types of uterine cancers -endometrial cancer and uterine sarcomas.The most common type of uterine cancer begins in the endometrium – the lining of the uterus, and is also called endometrial cancer. Uterine cancer occurs most often after menopause. Uterine sarcomas are rare types of cancer, and occur when cancer develops in the muscles or other supporting tissues in the uterus.
The cervix is the lower part of the uterus. Cervical cancer usually develops slowly over time. There are a series of changes before this cancer type appears.At the beginning abnormal cells begin to appear in the cervical tissue, a condition called dysplasia, which if not treated may turn into cancer. Usually it takes years for dysplasia to turn into cancer. One of the major causes of cervical cancer is considered a virus called Human papillomavirus (HPV). Other important risk factors include smoking, having many children, using birth control pills for a long time, or having HIV infection.
Testicular cancer affects men usually between the ages of 20 and 39, although it can occur at any age.More than 90% of cancers of the testicle develop in special cells known as germ cells. Seminomas and non-seminomas are the two major types of germ cell tumors in men. Many testicular cancers are of mixed forms, and contain both seminoma and non-seminoma cells. Seminomas tend to grow and spread more slowly than non-seminomas. The 2 main subtypes of these tumors are classical seminomas, and spermatocytic seminomas. Non-seminomas (embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, teratoma) usually occur in young men. Stromal tumorsdevelop in the supportive and hormone-producing tissues, and are more commonin childhood.
Skin cancer is considered as the most common form of cancer in some countries, such as the United States. According to some estimates millions of cases are newly diagnosed each year. This cancers are divided in two large cancer types – Non-melanoma and Melanoma skin cancers. The non-melanoma type is the most common, and widespread than any other form of cancer. Two of the common cancers of this type are the basal cell carcinoma and squamous cell carcinoma, which develop on the head, face, neck, hands, and arms. Non-melanoma types of skin cancer metastasize rarely to other bodily parts. Merkel cell carcinoma is rare and difficult to treat cancer type. Other non-melanoma cancers are Kaposi Sarcoma and Lymphoma of the Skin. Exposure to the sun UV rays is the main cause for skin cancers.
Melanoma is an extremely dangerous skin cancer type,starting in the melanocytes. Melanomas can be found anywhere on the skin, but there are some common locations for their appearance- the chest and the back in men; the legs – in women.It could appear on the neck,the face,more rarely – in the eyes, mouth, genitals and anal area. Unlike the non-melanomas, this aggressive cancer type is much more likely to spread to other parts of the body and is more difficult to treat.
Thyroid cancer is the most common of the endocrine cancer types.Papillary carcinomas are the most widespread thyroid cancers. Though this cancer develops slowly, and most often in one of the thyroid lobes,it can spread to the lymph nodes in the neck. The mixed papillary-follicular subtype of papillary cancers occurs more often than other(columnar, tall cell, insular, and diffuse sclerosing). Follicular carcinoma is also a common type. Rare types are – Hürthle cell carcinoma, Medullary thyroid carcinoma, Anaplastic carcinoma, Thyroid sarcoma.
There is no single cause for cancer; it is rather the interaction among numerous factors together leading to cancer. The risk factors contributing to cancer development in adults are: lifestyle; environmental factors (ultraviolet radiation, chemicals); genetic factors; virus exposure – the human papillomavirus (HPV), and HIV. Diagnosis, treatment, and prognosis depend on multiple factors. The specific way of treatment applied is determined by the type, location, grade of the cancer, and patient’s medical status. The most common treatments are surgery, chemotherapy, radiation therapy, and biological therapies, used alone or combined.
Surgery is the oldest primary treatment method of isolated solid cancers. It is used in several ways, playing an important part of confirming the definitive diagnosis and exact tumor stage. In cases, when the cancer is localized, curative surgery removes the entire tumor mass along with the surrounding tissues. Cryosurgery uses liquid nitrogen at extremely low temperatures to kill cancer cells. Laser surgery is a precise technique using light energy beams to shrink or destroy small tumors, with no damage to nearby tissues. This treatment can be used in body areas, difficult to reach (cervix, rectum, larynx). Skin and oral cancer cells can be eliminated with Electrosurgery – electrical current use. Microscopically controlled surgery is applied when the cancer is located in delicate parts of the body (the eye). Argon lasers are applied in the photodynamic therapy, activating specific chemicals in cancer cells, selectively destroying them while sparing the healthy cells.
Restorative surgery could be used after other surgeries to improve one’s appearance or body part functioning. After mastectomy, breast removal (Solin et al., 2008), women may need breast shape reconstruction. It could be rebuilt using plastic surgery, via breast implants (saline or silicone gel), or tissue taken from another body part.The reconstruction type depends on age, body type, and the surgery done. Breast-conserving surgery (lumpectomy) followed by localized radiation therapy, and chemotherapy with more than one drug, could be performed for treating women with early-stage breast cancer, instead of mastectomy.
Stem Cell Bone Marrow Transplants
Stem cells are the immature cells in the bone marrow giving birth to all blood cells. A bone marrow transplant is required in patients with leukemia, lymphoma, and multiple myeloma, or undergone chemotherapy that destroyed the bone marrow. The bone marrow that is damaged or does not work properly is replaced by a transplant. The transplants could be autologous – stem cells are removed from the patient before receiving intensive chemotherapy or radiation, stored in a freezer, and returned in the body to regenerate blood cells. Allogeneic bone marrow transplant is another type, in which stem cells are taken from another person (donor). Relatives are usually good matches. In umbilical cord blood transplant stem cells are removed from a newborn baby’s umbilical cord after birth, then frozen and stored until needed for a transplant.
Radiation therapy involves the application of ionizing radiation waves or particles to destroy cancer cells or prevent them from growing or reproducing. This cancer treatment provides a cure, control, or relief of symptoms. For certain types of cancer (head and neck cancer) radiation could be implemented alone, while for others, it often has to be accompanied by surgery and/or chemotherapy. With external radiation (external beam therapy), radiation is administered by a medical linear accelerator that points the radiation directly at the tumor. There are advanced radiation treatment methods, allowing the precise direction of the beams, particularly important in treating cancers adjacent to sensitive vital structures,or organs, such as the brain (three-dimensional conformal radiation therapy, intensity modulated radiotherapy, stereotactic radiation therapy). Through the internal radiation treatment (brachytherapy), radiation is supplied inside the body in close proximity to the cancer.
Chemotherapy is the implementation of one or more cytotoxic anti-neoplastic chemical agents to treat cancer. There are a large variety of various anticancer drugs, divided into two broad categories – alkylating agents and antimetabolites. These chemotherapy drugs kill cells that divide rapidly, including the cancer cells, or impede their ability to grow or reproduce. Targeted therapy is selectively targeting cancerous cells, destroying or inhibiting their growth (chronic myelogenous leukemia, breast cancer, multiple myeloma, lymphoma, prostate cancer, melanoma). One of the disadvantages is that chemotherapy is causing toxicity to other, normal and healthy tissues in the body, causing side effects during or after treatment. Chemotherapy may be used alone or in combination with other treatments.The chemotherapy drugs can be given as a pill, as an injection, intravenously, or applied to the skin.
Hormone therapy often involves taking medications influencing the activity of the hormone, or ceasing its production, but could also involve surgically removing a gland.The type of hormone therapy depends on many factors. This therapy is often applied to prevent the growth, spread, and recurrence of breast cancer. Clinical research has confirmed that the female hormone estrogen in certain cases stimulates the growth of breast cancer cells in some women. Some drugs block the action of estrogen on breast cancerous cell growth, others prevent estrogen production to stop the recurrence of breast cancer in postmenopausal women. Hormone therapy has also been used in prostate cancer treatment to stop the secretion of male hormones, which stimulate cancer to grow.
Biological therapy (immunotherapy, biotherapy) enhances the natural ability of the immune system to combat cancer. This type of therapy boosts the power of immune system cells, convert or stop the growth of cancer cells. The body’s ability to repair cells damaged by the disease or other forms of cancer treatment (chemotherapy or radiation) is improved. The immune system contains several types of blood cells (B cells, T cells, and natural killer cells) with a specific action against foreign or damaged cells, including cancer.These cells circulate throughout the body, providing protection from cancer and other diseases via the secretion of antibodies and cytokines.
Nonspecific immunomodulating agents are drugs (e.g. some plant extracts) applied often in biological therapy to stimulate the immune system, causing it to produce more cytokines and antibodies. Biological response modifiers (interferons, interleukins, colony-stimulating factors, monoclonal antibodies, etc.) are valuable in stimulating the body’s own ability to fight the disease. Interferons and interleukins occur naturally in the body, but can also be manufactured. They improve the immune system reaction against cancer cells directly, or changing their behavior. They stimulate the natural defensive blood cells in their action against cancer. Colony-stimulating factors are proteins, enhancing the production of blood cells to boost the suppressed immune system during or after chemotherapy. Monoclonal antibodies and are capable of connecting to cancer cells, making them recognizable by cancer-destroying agents introduced into the body, enabling the selective destruction of cancer cells.
A number of therapies, given after or in addition to the primary cancer treatment, are supportive – they do not cure cancer directly, but assist the main cancer treatments, improving their efficacy. An example could be the supportive chemotherapy and hormonal therapy with tamoxifen in treating breast cancer, while surgery has been the main treatment. Tamoxifen blocks the action of estrogen and stop the growth of some breast tumors. If a therapy is applied before the primary treatment, it is called neoadjuvant. It helps to destroy cancer cells, increasing the effectiveness of the primary therapy. A therapy given after the primary cancer treatment, is adjuvant, and is usually implemented to improve the chance of a cure. For example, hormone therapy in prostate cancer is supportive – it causes shrinking ofthe tumor, or hindering its progress.It is also helpful in alleviating the symptoms.
- Jatoi I, Proschan MA. Randomized trials of breast-conserving therapy versus mastectomy for primary breast cancer: a pooled analysis of updated results. Am J Clin Oncol. 2005;28:289–94.
- Solin LJ, Orel SG, Hwang WT, Harris EE, Schnall MD. Relationship of breast magnetic resonance imaging to outcome after breast-conservation treatment with radiation for women with early-stage invasive breast carcinoma or ductal carcinoma in situ. J Clin Oncol. 2008;26:386–91.
- Wittig JC, Bickels J, Priebat D, Jelinek J, Kellar-Graney K, Shmookler B, Malawer MM. Osteosarcoma: a multidisciplinary approach to diagnosis and treatment. Am Fam Physician 2002 Mar 15;65(6):1123-32.