Overview of common tumor treatment methods

At present, there are very few tumor diseases that can be overcome, and some early stage cancer cures have the possibility of cure. At this stage, the purpose of tumor treatment is mainly to improve disease symptoms, improve patients’ quality of survival and extend the survival period appropriately, and adopting multidisciplinary, multi-path and multi-method integrated treatment for tumor is the most reasonable method at present. Different tumors and different stages have their own corresponding treatment methods, and the opinions of doctors should be reasonably listened to. The purpose of this article is to make patients clear several methods of comprehensive tumor treatment, understand their advantages and disadvantages, and facilitate the selection. However, different tumors and different stages have their own corresponding treatment methods, not the treatment suitable for others is suitable for you. The common methods of tumor control are as follows: surgery, radiotherapy, chemotherapy, targeted therapy, immunotherapy, Chinese medicine therapy, and other methods such as interventional therapy, ablation therapy, etc. are not discussed. I. Surgery: used for diagnosis and radical treatment to relieve symptoms and improve survival, surgery can also achieve rehabilitation or reconstruction, palliative treatment for some advanced malignant tumors, such as: esophageal stent, bile duct stent, bile duct drainage, intestinal fistula, nerve block and many other methods. Early and middle stage cancer without local and distant metastasis and tumor is usually small, surgery is preferred. Disadvantages: Surgery is to remove the tumor locally, but the cancer cells that have spread to distant places and have not formed obvious masses throughout the body cannot be cut out, and some cancer cells can easily spread to other places with blood vessels and lymphatic vessels during surgery. Radiotherapy: radiation therapy is a local treatment method to treat tumor with radiation. Some head and neck tumors, breast cancer, lung cancer, gynecological tumors, bone tumors, etc. can be considered with the actual situation. Radiotherapy is a local treatment method and has certain limitations. Radiotherapy alone cannot solve extensive metastatic lesions. Radiotherapy uses high-dose radiation generated by special equipment to irradiate cancerous tumors to kill or destroy cancer cells and inhibit their growth, reproduction and spread. Although some normal cells are also damaged, most recover. Unlike chemotherapy, radiation therapy only affects the tumor and its surrounding areas, not the whole body. Side effects: Normal tissue reactions caused by radiation are generally divided into early primary reactions and late secondary reactions. Early radiation reactions generally refer to radiation-induced damage to the tissue cells themselves, as well as possible complications of inflammation. And late radiation reaction refers to radiation-induced occlusion of small blood vessels and connective tissue fibrosis which affects the function of tissues and organs, such as dry mouth caused by hypersecretion of glands, fibrosis contraction of lung, skin and subcutaneous tissues, etc. Chemotherapy: chemotherapy is the treatment of tumors with chemical drugs. Chemotherapy includes single drug for tumors with indications (i.e., choriocapillary epithelial carcinoma, hairy cell leukemia, chronic lymphocytic leukemia) that may be cured. Combination drug regimens based on different mechanisms of action, intracellular sites of action and toxicity (to reduce the potential for toxic additive effects) are often used, which can significantly increase the cure rate (e.g., acute leukemia, bladder and testicular cancer, malignant lymphoma, small cell lung cancer and nasopharyngeal carcinoma). Cure is achieved with chemotherapy alone in only 5% of tumors. For most solid tumors, other treatments are still needed. Disadvantage: Chemotherapy is not selective in killing cancer cells, and it kills a large number of normal cells while killing cancer cells, which eventually leads to the burning of jade and stone. Targeted therapy: The full name of targeted therapy for tumor is “molecular targeted drug therapy”, which is a unique therapy to make suitable anti-cancer drugs aim at the molecular targets on cancer cells and implement “precise strikes” to kill cancer cells. Such targets exist only in tumor cells, which are specific protein molecules, genes or pathways that play an important role in the survival and reproduction of cancer cells at the molecular level, and targeted drugs can be designed to target these targets. Targeted therapy is also called “biological missile”. It is precise and mild, with few side effects. Disadvantage: Targeted therapy requires genetic testing to detect the corresponding mutation target and then select the corresponding therapeutic target drug, which is only applicable to those cancer cells with mutations and specific proteins, but those cancer cells without specific proteins cannot be identified. If genetic mutation is found, targeted drugs should be used for treatment, but there is no effective targeted drug for the detected mutation point at this stage. If the test result is negative, the risk of disease progression and death will be increased if you take targeted drugs. At this stage, there are some broad-spectrum anti-angiogenic targeted drugs that do not require genetic testing because there is no way to determine which mutations are relevant to these targeted drugs, and there is also uncertainty as to their efficacy. For example: Anrotinib, Apatinib, Regorafenib, Sorafenib, Sunitinib, etc. Targeted drug therapy also has certain adverse reactions, for example: troche: diarrhea, rash, hepatotoxicity, etc.; ERSA: diarrhea, rash, pruritus, dry skin and acne, etc.; Gleevec: lower limb edema, rash, dyspepsia; sorafenib: hand-foot syndrome, fatigue, diarrhea, rash, hypertension, hair loss, etc.; cetuximab: rash, fatigue, diarrhea, nausea, pulmonary toxicity, fever, etc.; bevacizumab : gastrointestinal perforation, bleeding, hypertension, nephrotic syndrome, congestive heart failure, etc. Therefore, targeted drugs should not be eaten blindly, but need to be guided by a doctor, otherwise they bring related side effects and affect the quality of life. Immunotherapy: After surgery, radiotherapy, targeted therapy, another new revolution of tumor treatment. Immunotherapy is to regulate the immune function of the body to achieve the effect of anti-tumor. At present, the most applied ones are PD-1 inhibitors or PD-L1 inhibitors. The normal human organism will produce tumor cells every day and clear them by autoimmunity, among which T cells in white blood cells will play a big role. There is PD-1 protein on T cells in human body, and tumor cells produce PD-L1 protein to escape from T cells. After PD-L1 on tumor cells and PD-1 on T cells are combined, T cells cannot recognize tumor and cannot play the role of killing tumor. The common side effects of PD-1 are: rash, colitis, thyroid dysfunction, autoimmune hepatitis, immune-related pneumonia, etc. Chinese medicine treatment for tumor: Chinese medicine treatment for tumor has great advantages, especially in improving the quality of life, reducing the toxic side effects of radiotherapy and targeting immunotherapy side effects. Moreover, TCM treatment should accompany the whole process of tumor treatment. The specific advantages of TCM treatment and how to choose them are discussed in another article.