Multimodal Treatment of

Cancer1

Perjalanan klinis alami kanker non solid

Tumor jinak Tumor ganas

Metastasis

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Kanker• Sifat :

- bertumbuh dengan cepat

- tidak mempunyai tujuan

- merusak sekitarnya

- dapat bermetastase

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Treatment of Cancer• Surgery• Chemotherapy• Radiation therapy• Hormonal therapy• Immunotherapy• Bone marrow transplantation• Experimental treatment• Pain management• Palliative treatments• Alternative treatments 4

Multimodalitas treatment of cancer

• A multimodality approach is the use of one or more of the above weapons to fight cancer. For example, a patient with breast cancer initially will undergo surgery to remove the tumor, followed by chemotherapy and radiation therapy.

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Surgery• Surgery is the oldest method of treating cancers, with the

view to complete removal of the cancer from the body. Surgeons play many roles in management of cancer patient, including removing cancers, placing needed for treatment and at times, assisting with surgery in certain cancers is the most important aspect of the care and cure may not be possible without it. This is true in patients with non small cell, and many other cancers

Chemotherapy• Chemotherapy refers to the use of medication and

drugs (cytostatic) for treatment of cancer.6

Radiation Therapy• Radiotherapy or radiation treatment is the use

of x-rays, electrons or gamma rays to treat cancer. Radiation can cure or control cancer by inhibiting the cancer cells from dividing or reproducing.

• About fifty or sixty percent of patients with cancer will require radiation at sometime during their lifetime.

• Radiation is a safe and effective form of treatment for patients of all ages.

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Hormonal Therapy• Some cancers are dependent on certain

hormones for their growth, i.e. Breast, endometrial and prostate cancers. Manipulation of cancer and help in its control.

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A list of medications used to treatment of cancer

• Tamoxifen

• Zolodex

• Lupron

• Steroids

• Flutamide

• Casodex

• Arimidex

• Provera 9

Bone Marrow Transplantation (BMT)

• Bone marrow transplantation is a procedure by which certain illnesses and cancers may be cured. Bone marrow itself is the organ in charge of producing blood.

• This method was initially used in treatment of patients with severe bone marrow dysfunction. The goal was to replace the diseased marrow with healthy bone marrow.

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• The purpose of transplant is to actually produce a healthy bone marrow in patients. These conditions are :– Acute myeloid leukemia– Acute lymphoid leukemia– Chronic myeloid leukemia– Chronic lymphoid leukemia– Lymphomas that also involve the bone marrow

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• There are different types of transplantation. The type of transplantation depends solely on the donor and method of obtaining the bone marrow cells.

• Autologous, using patient’s own bone marrow.

• Allogeneic, using bone marrow from a sibling (brother, sister)

• Syngeneic, using bone marrow from an identical twin.

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Pain Management• Pain is a common problem among cancer patients.• There are several causes for pain :

– Due to the cancer– Procedures– Unrelated condition (arthritis)

• The most common cause of pain is spread of cancer to the nerves, bones, or other organs.

• This problem is frequently seen in patients who have advanced cancer.

• Pain should be relieved in all patients with proper treatment. Even mild pain can cause alterations of mood, physical and physicological functioning of a person

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Palliative Care• Most people view palliative care as treatment

of terminally ill cancer patients, where there is no more hope. The word palliation means to control the sign and symptoms of the disease.

• Many situations where the cancer is not terminal at all, however, patients are suffering from severe pain and discomfort. Pain management is one aspect of palliative care for cancer patients.

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Supportive Care• Intravenous fluid

• Diet : high calori and high protein

• Psychotherapy

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