Cancer impacts the community and the families that we have. But yet if I were to ask you, what is cancer and what do the treatments do, would you be able to come up with a simple answer? I know how hard it is to understand what cancer may be about because in reality, there are so many moving parts to cancer that it cannot be explained in one sitting. However, I can tell you that you are not alone in this and that there are techniques and treatments that can help target cancer more efficiently.  I’ll bet you are wondering where you would even start this process, so I am here to help with that.

I have studied only a little of its mechanisms over my undergraduate years and have over a year of experience in a cancer research laboratory. There I work on certain elements on cancer that can lead to a better outcome for the patient that can help protect healthy cells and not cancer cells. I understand  the mechanics of radiation and chemotherapy and how cells can be impacted by their toxicity. Not only this, but I also understand what is like to be a family member of someone receiving this treatment. No one gives you a “How-to guide” but I hope this helps you get started on how to look at treatments or maybe even what questions to ask.

After receiving diagnosis of cancer and the stage that it is at, you will probably head to google to understand what kind of treatments are out there and what is accessible to you. When first searching for treatments at the University of Iowa, a search engine will come up with numerous results, but let’s start simple. After searching “cancer treatments at the University of Iowa” and clicking the first link, there is a page that could lead you in any direction.

It may seem overwhelming where to click next, but I will help guide you through the website. The first place you would probably want to go then is “Diagnosis and Treatments”  in which the page should look like this:

Though this may be of simple design, there is so much that can be unpacked in each category. There are different cancer types, clinical trials, specialty programs and so forth. This blog will take you through each of these categories. The purpose of this blog is to help you understand what treatments are available, how wording can be misleading, and give you a clear set of tools or guidelines when looking at any treatment.

Cancer types (brain, liver, kidney, skin, etc.) are just that, the different types of cancer and what can cause a certain kind of cancer and some treatments for that. How you would treat brain cancer is different than how you would treat kidney so there are varying amounts of treatments and their outcomes with each cancer type. They will mention “innovative clinical trials” and put on how that will make it known to only YOU before it hits the wide public. However clinical trials sound almost experimental because “Clinical trials are research studies performed in people that are aimed at evaluating a medical, surgical, or behavioral intervention. They are the primary way that researchers find out if a new treatment, like a new drug or diet or medical device (for example, a pacemaker) is safe and effective in people” (https://www.nia.nih.gov/health/what-are-clinical-trials-and-studies). This means that the phase of testing of whether a drug works or not is still being tested. If a clinical trial was available and your family member fit the requirements, then that would be a whole other process, however we are going to be focused on treatments that have already been established.

Before getting into the treatments, you can also see a link for specialty programs. These programs are more for surgery like for the brain or breast and it also includes stem cell therapy which is basically a therapy that helps with replacing dead cells and can actually help with different treatments for cancer. However, there is an emphasis on the “may” help so please if this is something that you want to explore, please talk to your oncologist.

Now when clicking on “Treatment Options” please understand that there will be words that seem foreign but don’t worry I am going to talk you through them. When you scroll to view your options, you should see this screen:

Surgery, chemotherapy, and radiation are the first choices that are used to treat cancer. I know surgery is intimidating, especially where the cancer can be located, but this is used to get the tumors out. Depending on the stage of cancer, this process can take awhile. Though getting the majority of the cancer out of the body (if not all) is the goal. You may ask

                                         “Well the tumor is gone, why do any further treatments?”

Well, though the tumor may be gone, cancer cells can still be circulating or stabilized in a certain area. To kill off the remaining cells and to ensure that there is no more cancer, radiation and chemotherapy are used. Though this method works for the majority of the population, side effects are costly. The immune system becomes weaker and radiation is not usually the most targeted of the treatments. Radiation cannot identify healthy cells from cancer cells which is why the immune system weakens because your healthy cells that fight off infection or sickness are being targeted as well. Another problem that usually arises is that when starting chemotherapy and radiation, this is not a “one time” deal where you receive radiation and then get to go home. It takes reoccurring appointments that continuously undergo treatment and radiation in the body. Treatment can impact people differently over time and from my standpoint of working with radiation, it helps to keep something alive, but the point is to protect your healthy cells as well. Now please note people have beat cancer with these treatments, that’s why it is still so widely accepted, but to look beyond what has already established and find something this is more targeted may be your goal. You may ask yourself

                                                                          “What else is there?”

If you scroll a little further you will see what I will be mainly talking about.

Clicking the first option,  there is some information on additional treatment options such as Intraoperative Radiation Therapy (IORT). Basically the treatment is still using radiation, however it is to reduce the amount of times your family member would have to go back for radiation treatments. This can help with how much radiation they receive overall and it is more targeted, but know that this does not mean that it won’t kill your healthy cells as well as with just radiation, but it MAY decrease the number of healthy cells it may target. If this is something that seemed more accessible to you then talking to your doctor would be the next step, however there are more treatments to look through if radiation is something that still seems too much.

When looking at the immunotherapy section of the treatments, this is what the page would look like:

Now please know that you do need to know what all these words mean. These 4 options work through different mechanisms in order to treat cancer.

For the first category, monoclonal antibodies, they give a simple description of what they do. However, this does not entail how exactly it works or what makes it so different or the effectiveness of it compared to the rest of the treatments. Monoclonal antibodies boost natural immune response. This is a fancy way of telling you that this type of treatment helps your own immune system fight against cancer. For example, some monoclonal antibodies mark cancer cells so that the immune system will better recognize and destroy them. Now there are some specifics to this treatment, according to the Cancer National Institute (NIH) there is a list of cancers that have shown progress with this method. However, just like with any treatment, there are side effects which “The ones you may have and how they make you feel will depend on many factors, such as how healthy you are before treatment, your type of cancer, how advanced it is, the type of monoclonal antibody you are receiving, and the dose” https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/monoclonal-antibodies#which-cancers-are-treated-with-monoclonal-antibodies. There is then a list of symptoms that can be less sever like flu-like symptoms, or more severe. However if you have concerns with this, contact and ask your doctor what they think would be the right action for you and what their opinion is on for this treatment.

For the second category, it sounds similar to the first category in a way, but the difference is how they work. For immune checkpoint inhibitors, it “Immune checkpoints are a normal part of the immune system. Their role is to prevent an immune response from being so strong that it destroys healthy cells in the body.” (https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/checkpoint-inhibitors). However, this treatment works by preventing turning off the signal in our bodies which then enables our body to kill cancer cells. Though sounding similar to the first category, the list for cancers that this is effective for is shorter and more specified in the type of cancer you or your family member may have.

 “The side effects you may have and how they make you feel will depend on how healthy you are before treatment, your type of cancer, how advanced it is, the type of immune checkpoint inhibitor you are receiving, and the dose.” So please talk to your doctor about what possible side effects may occur and if you or your family member could benefit from this treatment.

The third category is cancer vaccines which sounds simple or like maybe foreign but it is more to help your body “identify” the cancer cells and fight against it. However, this again sounds similar but it is different in how it works. It works by identifying certain proteins on cancer cells and targeting them for cell death. Also this type of treatment can be personalized, meaning that it can be made for one specific person such as your family member or you. This is a way of finding a more personalized approach and not a general approach that most of these treatments have. However, there are two known vaccines from a reliable website (I will list websites that I find to be reliable at the bottom of this blog) which this is approved for:

However, Iowa may be different, there are cancer vaccines that are in clinical trials that could be offered to you. As you well know by now the side effects can be dependent on age, health, and the type of vaccine you receive.

The last category that is listed is cellular therapy, which is a more complicated process because it involves with people taking out your cells and modifying them a little bit. This sounds scary but it is similar to the other methods, only this time instead of injecting the body with a substance and having the cells have the treatment come to them, the doctors would take the cells out so it can come to the treatment. Then put back in your body to fight against cancer. The process is as follows, blood is taken from the body and there they find immune cells which fight cancer, they modify the cells by adding a targeting protien that is known to identify and kill cancer better. These new cells are then placed back into the body through an IV line. There are more steps to this process but that is more on how they get a certain protien onto the cell and there are only four FDA approved treatments such as :

However there are over 600 clinical trials being listed so if this was something that sounded like a more targeted approach then please talk to your doctor about possible treatment.

 

Blood and Marrow Transplants

For blood and marrow transplants, the goal is to help your body make new healthy cells. For cancer treatment there are harsh levels of treatment that can sometimes kill healthy cells. When this happens we want to replenish those healthy cells and this can be done with stem cells or blood and marrow transplants. The doctors will assess if you are free from infection and how your healthy organs are functioning.

Through all of this explaining you may be wondering,

                                             “Okay? So what do I do with all this information?”

I will now outline 5 steps for you to do from when the diagnosis is introduced and how to begin researching and understanding what possible treatments you should be focused on and how to begin your research as well.

5 Steps in the process

1. Cancer type: (Depending on the cancer type) Look up a certain treatment that has caught your attention from this blog on the Iowa website.
2. Research: Then once you have researched that topic on the Iowa website, do your own research. Find a certain treatment by looking up key words from the treatment that intrigued you.
1. Cancer.gov
2. Cancerreseach.org
3. Cancer.org
3. Success rates: Once on these websites, look for success rate and when the treatment was approved, the more recent the treatment is, the less we usually know about it. On this page they will also tell you if this treatment is used for other types of cancers and side effects
4. Jargon: Any words that are foreign or seem too much look up, there is always a simple definition or these websites are well suited in defining the treatments in words that are not confusing. Do not get intimidated by the mechanism that these treatments work
5. Doctor: Talk to your doctor about the treatment(s) that you are interested in; once you have their opinion ask for a suggestion of other possible treatments and start this process again.