NCCN Guidelines for Patients
: Caring for Adolescents and Young Adults
Part 5: Understanding your treatment options
example, a surgeon may insert a CVC (
atheter) or venous access port into one of your large
veins so your treatment team can give medication and
draw blood without constantly sticking you with needles.
Restorative (or reconstructive) surgery
is used to
repair damage caused by other cancer treatments.
The most familiar example of this kind of surgery is
breast reconstruction, in which a surgeon restores the
appearance of the breast after the removal of breast
Preventive (or prophylactic) surgery
that carries a high risk of becoming cancer, such as
precancerous polyps in the colon. Preventive surgery is
also an option for people with genetic mutations that put
them at risk for certain cancers. For example, a woman
with cancer in one breast who has the gene mutation
associated with a high risk for breast cancer may choose
to have her healthy breast removed (prophylactic
mastectomy) to ensure that cancer won’t develop.
Radiation therapy uses high-energy particles or rays
to kill cancer cells and/or damage the cells’ DNA so
they can no longer grow or divide. Radiation can be
administered in three ways: external beam radiation,
internal radiation (also known as brachytherapy), and
systemic radiation therapy.
Treatment types: Systemic therapies
Systemic therapies are the ground troops of the cancer
treatment world. Some go after all rapidly dividing cells
in the body (chemotherapy), some zero in on particular
characteristics of cancer cells (targeted therapy), and
some recruit your body’s natural defenses to recognize
and destroy cancer (immune therapy).
Because systemic therapies go after cancer in a many
different ways, doctors will often use different medications
in combination to get the biggest treatment effect. This
strategy can increase the chances of getting rid of the
cancer, but it also increases the risk that healthy cells
will get caught in the crossfire, leading to side effects
that may make it necessary to stop or delay treatment or
change the treatment approach.
Chemotherapy, or chemo, is the mainstay of systemic
cancer treatment. All chemotherapy drugs interfere with
the genetic machinery that cells use to grow and divide.
Some damage DNA directly; others get in the way of
processes that help cancer cells build DNA (Table 4).
Many chemotherapy drugs are given as liquids that are
slowly injected into a vein, a CVC, or a port. Some are
pills that are given by mouth. Chemotherapy may also be
placed directly into a body cavity (such as the bladder,
abdomen, or the space around the brain and spinal cord)
so it can be delivered straight to the cancer cells without
having to go through the bloodstream.