Cancer Treatment

Treatment Overview

Introduction to Cancer Treatment

Prostate Cancer Treatment
This section is design for men diagnosed with prostate cancer and their loved ones and/or caregivers. The information below assumes that the cancer has been staged.

Choice of cancer treatment is influenced by several factors, including:

The specific nature of your cancer; your overall condition
Whether the goal of treatment is to cure your cancer, or
Keep your cancer from spreading, or
To relieve the symptoms caused by cancer.

Depending on these factors, you may undergo one or more of the following:

Watchful waiting
Surgery
Radiation therapy
Hormone therapy
Cyrosurgery/Cryotherapy
Biologic/Immunotherapy
High-intensity focused ultrasound
Participate in Cancer Trials

Personalized Cancer Care means there is no longer a “one-size-fits-all” approach to cancer treatment. This is the kind of care that we provide at Philadelphia Cancer Treatment. Personalized cancer care is also an important part of our Clubcare™ approach.

What personalized cancer care means to you. Even amongst patients with the same type of cancer, the behavior of the cancer and its response to treatment can vary widely. Specific characteristics of cancer cells and cancer patients can have a profound impact on treatment outcome. Taking these personal differences into account, offers the promise of improved outcomes but also makes cancer care more complex. That means that delivering complex cancer care that is specific to your needs requires a highly trained and dedicated team of professionals.

How does personalized cancer care relate to Clubcare™? Clubcare takes personalized cancer care a step further. It puts the person with cancer at the center of everything we do; a relaxed state of mind, physical comfort when at our treatment facility, speed and efficiency in our office procedures so that waiting times are short and our patients’ experience is stress-free. Extended support during treatment but even after treatment has ended.

Clubcare™ is all about a calm atmosphere and comfort, the best possible environment for administering personalized cancer therapy to get you better.

1. Watchful waiting is used with patients who have mild or no symptoms. We will monitor you closely, watching for cancer growth and any changes in symptoms.

2. Surgery is used to diagnose cancer, determine its stage, and to treat cancer. One common type of surgery that may be used to help with diagnosing cancer is a biopsy. A biopsy involves taking a tissue sample from the suspected cancer. A specialist then examines the biopsied tissue in a laboratory. A biopsy is often performed in the physician’s office or in an outpatient surgery center. A positive biopsy shows the presence of cancer; a negative biopsy may show that no cancer is present in the sample.

When surgery is used for treatment, the cancer and some tissue nearby are typically removed. Furthermore, valuable information is gained during surgery. This information is useful in predicting the chance of the cancer occurring again. It can also tell your cancer treatment team whether any other treatments are needed.

Patients who are good candidates for surgery may undergo one of the following:

#	Type of Surgery	Description
1	Pelvic lymphadenectomy	Removes the lymph nodes in the pelvis if they are cancerous
2	Radical prostatectomy	Removes the prostate, surrounding tissue, and seminal vesicles
	Retropubic Prostatectomy	Removes the prostate through a cut in the abdominal wall. Lymph nodes may also be removed
	Perineal Prostatectomy	Removes the prostate through a cut made in the perineum (area between the scrotum and anus), nearby lymph nodes may also be removed
3	Transurethral resection of the prostate (TURP)	Removes tissue from the prostate through the urethra.

3. Radiation therapy uses x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy; 1) external radiation therapy, which uses a machine to irradiate the cancer, 2) internal radiation therapy uses a radioactive material sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.At Philadelphia Cancer Treatment’s Radiation Oncology Center, our systems use the newest improvements in radiation technology.

Image Guided Radiation Technology (IGRT)

IGRT improves the accuracy of the radiation therapy to limit damage to surrounding healthy body tissue. This is important in prostate cancer. The prostate requires high doses of radiation to destroy cancer cells but is close to the bladder and rectum, which are sensitive to radiation. Furthermore, the prostate is an organ that can move. During planning and treatment, computed tomography is used to take 3-D images frequently. Comparing these images allows our
team to determine the latest organ position and to adjust the radiation field during treatment.

Intensity-Modulated Radiation Therapy (IMRT)

IMRT is a high-precision radiation targeting system that enables the radiation team to “paint” a tumor in three dimensions with a single powerful beam composed of hundreds of smaller beams. The smaller beams bypass healthy tissue, avoiding damage, until they coalesce into a single powerful beam that destroys the tumor.

RapidArc Volumetric Therapy (VMAT)

RapidArcTM is a technology that improves the consistency of the radiation dose while making treatment up to eight times faster. It allows the beam to irradiate the entire tumor rather than
irradiating it in segments as with older technologies.

4. Hormone therapy is a cancer treatment that removes or blocks hormones that contribute to cancer cell growth. Hormone levels can also be affected by surgery (orchiectomy) that removes one or both testicles, the source of male hormones and a factor in prostate cancer growth.

5. Cryosurgery/Cryotherapy freezes and destroys prostate cancer cells.

6. Biologic/Immunotherapy uses the patient’s immune system to fight cancer. Natural or manmade substances boost, direct, or restore immune defenses against cancer.

7. High-intensity focused ultrasound uses high-energy sound waves to destroy cancer cells.

8. Cancer Trials: Philadelphia Cancer Treatment staff is committed to research and learning and actively participates in studies of new cancer drugs or procedures. Ask us about the studies in which we are participating.

Bladder Cancer Treatment

This section is design for those diagnosed with bladder cancer and their loved ones and/or caregivers. The information below assumes that the cancer has been staged.

There are three types of bladder cancer. They are named after the different cells in the bladder: transitional, squamous, and secretory.

Stage	Alternate Designation	Description
0	T₀	Also called papillary carcinoma and carcinoma in situ) means that abnormal cells were found in tissue lining the inside of the bladder.
I	T₁	Cancer involves the layer of tissue under the inner lining of the bladder.
II	T₂	Involves the inner half or outer half of the muscle wall of the bladder.
III	T₃	Cancer is in the fatty tissue surrounding the bladder and may have found its way to the reproductive organs (prostate, uterus or vagina).
IV	T₄	Cancer involves the bladder, and the wall of the abdomen or pelvis. The lymph nodes may also be involved.

Choice of cancer treatment is influenced by several factors, including:

The specific nature of your cancer; your overall condition
Whether the goal of treatment is to cure your cancer, or
Keep your cancer from spreading, or
To relieve the symptoms caused by cancer.

Depending on these factors, you may undergo one or more of the following:

Surgery
Radiation therapy
Chemotherapy
Biologic/Immunotherapy
Chemoprevention
Photodynamic therapy
Participate in Cancer Trials

Personalized Cancer Care means there is no longer a “one-size-fits-all” approach to cancer treatment. This is the kind of care that we provide at the Philadelphia Cancer Treatment. Personalized cancer care is also an important part of our Clubcare™ approach.

Clubcare™ is all about a calm atmosphere and comfort, the best possible environment for administering personalized cancer therapy to get you better.

1. Surgery

Four kinds of surgery may be performed on patients with bladder cancer: Transurethral resection, radical cystectomy, segmental cystectomy, and urinary diversion.

#	Type of Surgery	Description
1	Transurethral resection	Uses a cystoscope (a thin tube with a light at the end of it) inserted through the urethra into the bladder where cancerous tissue is either burned or removed with electricity (called fulgation)
2	Radical Cystectomy	Removes the bladder, lymph nodes, and nearby organs that are cancerous. In men, the organs removed might be the seminal vesicles and the prostate; in women, it would be the uterus, ovaries and part of the vagina.
3	Segmental Cystectomy	Removes the cancerous part of the bladder. It is usually performed on low-grade tumors that invade the bladder wall but are localized.
4	Urinary Diversion	Provides another route for urine to leave the body.

2. Radiation therapy uses x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy; 1) external radiation therapy, which uses a machine to irradiate the cancer, 2) internal radiation therapy uses a radioactive material sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

3. Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.

Systemic Chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body.
Regional Chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen. The medication mainly affects cancer cells in those areas Bladder cancer may be treated with intravesical (into the bladder through a tube inserted into the urethra) chemotherapy. The way the chemotherapy is given depends on the type and stage of the cancer being treated.

4. Biologic therapy uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.

5. Chemoprevention uses drugs, vitamins, or other substances to reduce the risk of developing cancer or to reduce the risk that cancer will recur.

6. Photodynamic therapy uses a drug and a specific type of light to kill cancer cells. A drug that is not active until it is exposed to light is injected into a vein. The drug collects more in cancer cells than in normal cells. Fiberoptic tubes are then used to carry the laser light to the cancer cells, where the drug becomes active and kills the cells. Photodynamic therapy causes little damage to healthy tissue.

7. Cancer Trials: Philadelphia Cancer Treatments staff is committed to research and learning and actively participates in studies of new cancer drugs or procedures. Ask us about the studies in which we are participating.