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TREATMENT OF TUMORS Maša Radeljak Mentor: A. Žmegač Horvat GOALS OF TREATMENT • • • • Complete removal Palliation Amelioration of symptoms Preservation of quality of life TREATMENT OF TUMORS • • • • Surgery Radiation therapy Chemotherapy Biologic therapy TREATMENT OF TUMORS ADJUVANT • Given after the primary treatment • Chemotherapy, radiation therapy, biologic therapy NEOADJUVANT • First step before the main treatment • Chemotherapy, radiation therapy SURGERY • Preventionresection of premalignant lesions • Diagnosisexcisional biopsy, incisional biopsy, core-needle biopsy, fine-needle aspiration SURGERY • Stagingdetermining the extent of the disease and whether it has metastasized to regional lymph nodes SURGERY - TREATMENT • • • • • • • • Most effective therapy 40% Complete excision Local control of tumor Preservation of organ function Resection of metastatic disease Staging information Mastectomy, prostatectomy, lung cancer surgery SURGERY • Palliationsupportive care, pain management, insertion of central venous catheters, ascites • Rehabilitationbreast reconstruction, orthopedic procedures RADIATION THERAPY • • • • • Target tissue Genetic material Free radicals Oxygen X-rays and gamma rays • Teletherapy, brachytherapy, systemic therapy with radionuclides TELETHERAPY • External beam radiotherapy • Linear accelerators • Most commonly used form of radiation • Breast, head and neck cancer, Hodgkin's disease BRACHYTHERAPY • Internal radiotherapy • Inside or next to the tumor • Temporary or permanent • Cervical, brain, skin and prostate cancer CHEMOTHERAPY • Cytotoxic drugs • Rapidly dividing cells • Alkylating agents • Antimetabolites • Plant alkaloids and terpenoids • Topoisomerase inhibitors • Antitumor antibiotics • Hormonal agents TOXICITY • • • • • • Nausea Vomiting Myelosuppression Mucositis Alopecia Gonadal dysfunction BIOLOGIC THERAPY • • • • Immune mediators Antibodies Cytokines Angiogenesis inhibitors REFERENCES • http://en.wikipedia.org/wiki/Cancer_treatm ent • Harrison: Principles of Internal Medicine