Categorization of Treatment Options

The therapy options in cancer are classically divided into three groups

  1. Surgery

  2. Radiotherapy

  3. Chemotherapy (or Drugs)

They are also called “the three column of cancer therapy”. In the meantime the immunotherapy seems to arise as a forth column.

If one tries to include all possible therapy options which are available today one can use the above classification but extend them to more general categories. These categories are:

  1. Mechanical Methods (includes surgery)

  2. Physical Methods (includes radiotherapy)

  3. Chemical Methods (includes chemotherapy)

  4. Biological Methods (includes immunotherapy)

Image about the therapeutic options in cancer

Below these four categories are discussed:

1. Mechanical Methods

For mechanical methods the surgery is the main method. Today there are many different versions available. The range exists from very gentle methods (like minimal invasive surgery) up to extensive and stressful alternatives, in which the surgeon tries to remove single or multiple entire organs, which are affected by cancer.

2. Physical Methods (including radiotherapy)

This category covers all methods which utilize physical properties to fight against cancer. The classical treatment by radiotherapy belongs to it as well as treatments using other radiation like proton and ion-beam therapies and hyperthermia.

3. Chemical Methods (including chemotherapy)

In this category one can find all types of treatments which utilizes drugs. The are different subtypes of drugs, which are:

  • classical chemotherapeutic drugs, which are used for chemotherapy,
  • new targeted drugs, which target special structures within or at the cancer cells,
    • (anti-)hormonal drugs, which fight against the hormone-dependency of tumors and
  • cytokines, which try to modulate the immune system positively against the cancer.

In our definition of targeted drugs the (anti-)hormonal drugs do belong to this drug category.

The cytokines and some new targeted drugs are sometimes also called immunotherapies. The experts still differ in their definitions.

4. Biological Methods (including immunotherapy)

In this category all methods are included which fight against cancer utilizing biological functions. In this respect the immunotherapy seems to be the most promising approach. In the literature sometimes even drugs, like cytokines and new targeted drugs (here the antibodies) are called immunotherapeutic approaches. According to our classification we put them into the chemical method section. Immunotherapies are in particular methods like the immune vaccination. The idea is to administer the patient its entire tumor or parts of it as a vaccine so that the immune system will learn to recognize the tumor.

Another biological alternative is the gene therapy. Here the cancer cells are tried to be reprogrammed by putting genetic code into the cells. The idea is that the cancer cells will lose their cancer potential and will either die or turn back to normal. This approach currently is far from normal clinical application.

Aug 19, 2016 By Dr. Frank Kischkel