Cancer modalities

Cancer or neoplastic disease is a genomic disorder of the body s own cells which start to proliferate and metastasize in an uncontrolled fashion that is ultimately detrimental to the individual. Antineoplastic agents are used in conjunction with surgery and radiotherapy to restrain that growth with curative or palliative intention. The domain of antineoplastic chemotherapy is cancer that is disseminated and therefore not amenable to local treatment modalities such as surgery and radiotherapy. 

List all modalities that are appropriate screening tools for breast cancer and determine how they should best be used in the public domain. 

Surgery is the primary treatment modality for nonmelanoma and melanoma skin cancer. 

The modality of treatment for skin cancer depends on the size, location, and stage of the tumor the age of the patient and the type of skin cancer. Treatment options for skin cancer include surgery, radiation, chemotherapy, and immunotherapy. 

Surgery is the primary treatment modality for NMSC and MM. Surgical approaches for skin cancer are divided into two different categories (1) superficial ablative techniques that include electro desiccation and curettage (ED C) and cryotherapy... 

Chemotherapy is the primary treatment modality for metastatic colorectal cancer (MCRC). Treatment options are generally similar for metastatic cancer of the colon and rectum. 

The major initial treatment modality for advanced prostate cancer is androgen ablation (e.g., orchiectomy or luteinizing hormone-releasing hormone [LHRH] agonists with or without antiandrogens). After disease progression, secondary hormonal manipulations, cytotoxic chemotherapy, and supportive care are used. 

Thermal ablation using carbon nanotubes is a definite option for use in oncology, especially since nanotubes can be functionalized with targeting modalities like folic acid. Some cancer cell types express large numbers of folic acid receptors on... 

Non-surgical methods of cancer treatment, primarily radiation therapy and chemotherapy, rely almost exclusively on procedures that kill cells. The main problem with these treatments is that they do not provide specificity for cancer cells. In the case of radiation therapy, a degree of specificity is achieved by localizing the radiation to the tumour and its immediate surrounding normal tissue. For anti-cancer drugs, it is primarily the rapid proliferation of many of the cancer cells that makes them more sensitive to cell killing than their normal counterparts. However, both modalities are limited by their cytotoxic effects on normal cells. In the case of radiotherapy, normal tissue surrounding the tumour limits the radiation dose, where-... 

Encapsulation of immunomodulators, e.g. muramyl tripeptide analogues, into liposomes has been designed to stimulate host immunity [108] and can be used in combination with other treatment modalities. The systemic activation of macrophages provides an additional therapeutic modality for the eradication of cancer and cancer metastases. 

Abstract Inhibitors of the kinases controlling the cell cycle have emerged as an important therapeutic modality for the treatment of cancer. Drug discovery efforts have focused on inhibitors of the cyclin-dependent kinases, the Aurora kinases, and Polo-like kinases. Agents for each kinase are now advancing in human clinical trials. In this review we will summarize the work in this area with special emphasis on the structural biology and structure-activity relationships developed for the many chemotypes explored. 

Spatial cooperation is a term coined to describe a situation when disease in one particular anatomic site is missed by one modality but is treated adequately by another. The essence of this is that radiation is a local therapy that will not impact on metastatic disease beyond the planned field borders. Systemic cytotoxic chemotherapy is traditionally used to address the potential distant spread of cancer. In the original description of this mechanism there is no assumption of an interaction between the drugs and radiation with the idea being that the best radiation and best chemotherapy be administered independently of toxicities. The classic example used in several textbooks to illustrate this is the treatment of childhood leukemia with systemic chemotherapy, while their central nervous system, a potential sanctuary site where disease is not treated adequately by chemotherapy, is treated by radiation (28). The reality of the interaction between radiation and chemotherapy is that the dose and timing of radiation are adjusted accordingly to minimize their impact on the neural tissues. 

UFT was studied in combination with radiation therapy in patients with locally advanced, inoperable gastric carcinoma. Tsukiyama et al. (66) evaluated combined modality therapy (CMT) consisting of UFT and mitomycin-C administered together with radiation therapy, and reported local control in 70% of patients with advanced inoperable gastric cancer. 

Gastrointestinal Tumor Study Group. Treatment of locally unresectable carcinoma of the pancreas comparison of combined-modality therapy (chemotherapy plus radiotherapy) to chemotherapy alone. J Natl Cancer Inst 1988 80 751-755. 

The initial combination modality clinical studies with cisplatin and fractionated radiation therapy was carried out in head and neck cancer with weekly cisplatin (120-160 mg/m2) and conventional single daily fraction radiation (95). In a follow-up intergroup study, patients were randomized to radiation therapy alone or to radiation therapy plus 20 mg/ m2/wk cisplatin (96). Both studies showed no major increase in normal tissue toxicity in the radiation field and showed an increase in response rate. There was no increase in complete response rate or in survival. Bachaud et al.(97) carried out a randomized study comparing radiation therapy alone with concurrent cisplatin (50 mg/m2) and radiation therapy in postoperative patients. This trial produced a significant reduction in local recurrence and improved disease-free survival with 59% of the patients receiving the full planned dose of cisplatin. 

Within the multiple subsites of this tumor grouping, most work has been done in esophageal cancer. The large majority of these patients have been treated with paclitaxel in combination with radiation (Table 3). The experience with docetaxel is essentially limited to patients treated on phase I trials for thoracic malignancies that used radiation in combination with docetaxel (68,111). The situation is much the same for both pancreatic and gastric cancers as well. The rationale for looking at combination therapy that incorporates paclitaxel is much the same as in other disease sites, i.e., its activity in systemic disease (112), its potent preclinical radiosensitizing properties (38), and evidence from randomized trials that there is a benefit to combined modality therapy that includes at least radiation and chemotherapy (113-116). 

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