Biomarkers That Affect Treatment Decisions
Oncologists use biomarkers to help determine whether immunotherapy, chemotherapy or a combination of the two may be an appropriate treatment for a cancer patient. While researchers continue to look for other useful biomarkers, three of particular importance help determine whether immunotherapy is a treatment option. They are:
PD-L1: The biomarker PD-L1 is a protein thats expressed in tumor cells, telling the immune system not to attack a particular cancer cell. If the PD-L1 expression level is high, say above 50 percent, then immunotherapy by itself may be recommended. The lower the percentage, the more likely the patient will undergo chemotherapy. However, even in those cases, immunotherapy may still be of some benefit. When the numbers are low, chemotherapy can be usedthats fine. But we can add immunotherapy to really enhance the response, Dr. Loaiza-Bonilla says.
Tumor mutational burden . With PD-L1, doctors conduct tests to determine the percentage of cells with that biomarker. With MSI-high, they check for the presence of four proteins that facilitate DNA repair. Tests for tumor mutational burden require a full genome readout, called next-generation sequencing. These tests measure the density of mutations in a tumor. The higher the concentration of mutations, the more likely immunotherapy will have an impact.
Dr. Loaiza-Bonilla compares the mutations in a tumor to typos on the pages of a book.
Why People With Cancer Are More Likely To Get Infections
People with cancer may have a higher risk of infection because of changes in the immune system that control their bodys defense systems. Cancer and cancer treatments can affect the immune system and other body systems in different ways. People with cancer might be more likely to get infections because of:
- The cancer itself
- Certain types of cancer treatment
- Other health problems or medications that aren’t related to cancer
Your cancer care team will talk to you about any increased risk for infection you may have, and what can be done to help prevent infection. If the risk is due to cancer treatment, it is usually temporary because the immune system recovers after a period of time, but this depends on your situation. You can learn more in Watching for and Preventing Infections in People With Cancer.
If you have questions about whether you need to take special precautions to prevent infections, it is best to discuss your risk of getting an infection with a doctor who understands your situation and medical history.
Were In This Together
The Cancer Therapies Toolkit is the most extensive, in-depth resource on cancer Ive ever given away for free. Please share it with someone who might benefit from this knowledge. Together we can help people all over the world find some relief.
I hope the toolkit gives you the comfort, guidance and practical advice you need right now. And please remember that no matter what youre facing, you are a strong, sensational, resilient, one-of-a-kind soul. Cancer cant take that away from you.
One last tip before I turn it over to you: Bless your treatment. Fill it with your love and light. Imagine it healing your body. Picturing it restoring your health. Imbue it with your positive energy. Thats some of the best medicine around.
Your turn: What side effects have you faced during cancer treatment and how have you found relief? Lets share ideas and support each other in the comments below!
Peace & healing,
My first book, Crazy Sexy Cancer Tips, covers everything from choosing an oncologist and building an all-star medical team, to navigating your social life and your kitchen post-diagnosis. Its a must-have resource for patients, thrivers, survivors and caregivers alikepick it up here!
Don’t Miss: Lower Abdominal Pain Radiating To Back
What Can You Not Do During Radiation Treatment
Avoid raw vegetables and fruits, and other hard, dry foods such as chips or pretzels. Its also best to avoid salty, spicy or acidic foods if you are experiencing these symptoms. Your care team can recommend nutrient-based oral care solutions if you are experiencing mucositis or mouth sores caused by cancer treatment.
If Youre Getting Radiation Therapy To The Brain
People with brain tumors often get stereotactic radiosurgery if the cancer is in only one or a few sites in the brain. Side effects depend on where the radiation is aimed. Some side effects might show up quickly, but others might not show up until 1 to 2 years after treatment. Talk with your radiation oncologist about what to watch for and when to call your doctor.
If the cancer is in many areas, sometimes the whole brain is treated with radiation. The side effects of whole brain radiation therapy may not be noticeable until a few weeks after treatment begins.
Radiation to the brain can cause these short-term side effects:
- Trouble with memory and speech
Some of these side effects can happen because radiation has caused the brain to swell. Medicines are usually given to prevent brain swelling, but its important to let your cancer care team know about headaches or any other symptoms. Treatment can affect each person differently, and you may not have these particular side effects.
Radiation to the brain can also have side effects that show up later usually from 6 months to many years after treatment ends. These delayed effects can include serious problems such as memory loss, stroke-like symptoms, and poor brain function. You may also have an increased risk of having another tumor in the area, although this is not common.
Talk with your cancer care team about what to expect from your specific treatment plan.
Also Check: Neuropathy In Feet From Chemo
Chemotherapy Vs Radiation Therapy
There are 4 major types of treatment for cancer radiation, chemotherapy , surgery and biologic therapies. Chemotherapy uses very strong drugs, and radiation therapy uses high energy waves to treat the disease by killing cancer cells. Radiation therapy is targeted to localized cancer i.e., specific organs in the body where cancerous tissue is present. Chemotherapy can be used when cancer cells have spread to other parts of the body.
What Else Do I Need To Know About Radiation Therapy Treatment Appointments
During your treatment period, your radiation oncologist will check how well radiation therapy is working. Typically, this will happen at least once a week. If needed, they may adjust your treatment plan.
While being treated, many people experience fatigue and sensitive skin at the site of radiation therapy. You may also experience emotional distress during radiation therapy. It is important to rest and take care of yourself during radiation therapy. Consider these ways to take care of yourself:
Before You Have Radiotherapy
Before you start your treatment, it needs to be planned carefully by your radiotherapy team. This is to make sure the radiotherapy is aimed precisely at the cancer, causing as little damage as possible to surrounding tissue.
Your team will explain what the treatment involves and will ask you to sign a consent form. This gives your team permission to give you treatment.
There are some things you should consider before having radiotherapy:
If you would like to talk about your treatment or how you are feeling, Macmillan is here to support you. You can do the following:
Side Effects Of Radiation Therapy
- Skin conditions: Dry, inflammed skin at the radiation site or the development of breakdown or blistering.
- Fatigue and stiffness: Can be seen in many patients undergoing radiation, usually toward the latter part of treatment.
- Swelling : Is usually more associated with the presence of a tumor or recent surgery. Delayed development of swelling from radiation alone is less common, with modern treatment regimens and techniques.
- Other complications: The possible development of secondary cancers
Recommended Reading: Prevent Eyebrow Loss During Chemo
Does Radiation Therapy Cause Cancer
It has long been known that radiation therapy can slightly raise the risk of getting another cancer. Its one of the possible side effects of treatment that doctors have to think about when they weigh the benefits and risks of each treatment. For the most part, the risk of a second cancer from these treatments is small and is outweighed by the benefit of treating the cancer, but the risk is not zero. This is one of the many reasons each case is different and each person must be part of deciding which kind of treatment is right for them. The risk is different depending on where the radiation treatment will be in the body.
If your cancer care team recommends radiation treatment, its because they believe that the benefits youll get from it will outweigh the possible side effects. Still, this is your decision to make. Knowing as much as you can about the possible benefits and risks can help you be sure that radiation therapy is best for you.
You May Like: Chemo Hair Loss Head Coverings
Whats Worse Radiotherapy Or Chemotherapy
Because radiation treatment focuses on a single part of your body, it may have less adverse effects than chemotherapy. However, it may still have an impact on healthy cells in your body. Radiation can cause digestive problems such as nausea, vomiting, stomach cramps, and diarrhea. It can also affect the immune system and blood cells. Infertility is also an issue for men who receive radiation treatments.
Chemotherapy affects many parts of your body at once, so it has more side effects than radiation therapy. Chemotherapy drugs are designed to kill cancer cells, but they also attack healthy cells, especially cells that are dividing , causing them to become dysfunctional or die. Healthy cells that divide often include cells needed to maintain muscle tissue, hair, and skin. With time, even normal cells can become depleted due to the cytotoxic effects of chemotherapy. Long-term effects depend on the type of chemotherapy drug used some people suffer from long-term side effects such as fatigue, pain, reduced immunity, and cognitive impairment while others appear to recover fully after chemotherapy.
Radiation therapy and chemotherapy both have advantages and disadvantages. If you are able to choose between these two types of treatments, we recommend radiation therapy because it causes fewer side effects overall. But if you need both therapies to achieve complete remission of your disease, thats okay too.
Read Also: Side Effects Of Thyroid Cancer
Types Of Radiation Therapy
Radiation can be administered in two ways: internally or externally:
External: External beam radiation is delivered from a machine. It is very similar to receiving a chest X-ray. Most people are treated five days a week for one to 10 weeks, depending on the type and location of cancer, their overall health, and other factors. The treatment only takes a few minutes, and is not generally given over the weekend.
You will be asked to lie flat on a treatment table, under the radiation machine. Other parts of your body may be protected with special shields or blocks to prevent the radiation from going to those areas.
External treatments include:
- 3D conformal radiation therapy after the tumor is mapped through imaging, beams of radiation treat the cancerous tumor.
- Intensity-modulated radiation therapy gives the radiation oncologists the ability to more precisely custom sculpt the shape of the tumor. This helps deliver the right amount of radiation more accurately, as well as helps to preserve healthy tissue surrounding the tumor.
Internal: Radiation that is placed inside of the body is called internal radiation therapy or brachytherapy. A radioactive source, called an implant, is placed directly to the tumor or near the tumor. This delivers large doses of radiation to directly to the source of your cancer. These implants may look like a wire, pellet, or seeds.
The most common types of cancers treated with internal radiation therapy are:
Nursing Allied Health And Interprofessional Team Interventions
Nursing interventions and patient education play an essential role in reducing the side effects of radiotherapy. Specific strategies that can be useful include:
Don’t Miss: Does Blurry Vision From Chemo Go Away
What Do You Say At The End Of Chemo
What to Say to a Cancer Patient
- Well get through this together.
- I am praying for you.
- Go to MD Anderson.
- I am here for you. Then follow through and really be there.
- Dont ask what you can do to help or say, Let me know if you need anything. Many people will never ask for help even though they need it.
How Your Information Is Secured And Retained
We take reasonable security measures to protect the security of your personal information. Despite WebMDs efforts to protect your personal information, there is always some risk that an unauthorized third party may find a way around our security systems or that transmissions of your information over the Internet may be intercepted.
The security of your personal information is important to us. When you enter personal information , we encrypt the transmission of that information or use SSL connections technology.
We will retain your personal information as long as your account is active or as needed to provide you Services. At any time you can remove your personal information or instruct us to remove it, but you should be aware that it is not technologically possible to remove each and every record of the information you have provided to WebMD from our servers. See Your Choices and Rights below for more information on how you can update or remove your personal information. We will also retain your personal information as necessary to comply with legal obligations, resolve disputes and enforce our agreements.
Read Also: Food To Eat During Chemo
Read Also: What To Expect After Chemo
If Youre Getting Radiation Therapy To The Abdomen
If you are getting radiation to your stomach or some part of the abdomen , you may have side effects such as:
Eating or avoiding certain foods can help with some of these problems, so diet planning is an important part of radiation treatment of the stomach or abdomen. Ask your cancer care team about what you can expect, and what medicines you should take to help relieve these problems. Check with your cancer care team about any home remedies or over-the-counter drugs youre thinking about using.
These problems should get better when treatment is over.
Some people feel queasy for a few hours right after radiation therapy. If you have this problem, try not eating for a couple of hours before and after your treatment. You may handle the treatment better on an empty stomach. If the problem doesnt go away, ask your cancer care team about medicines to help prevent and treat nausea. Be sure to take the medicine exactly as you are told to do.
If you notice nausea before your treatment, try eating a bland snack, like toast or crackers, and try to relax as much as possible. See Nausea and Vomiting to get tips to help an upset stomach and learn more about how to manage these side effects.
Many people have diarrhea at some point after starting radiation therapy to the abdomen. Your cancer care team may prescribe medicines or give you special instructions to help with the problem. Diet changes may also be recommended, such as:
Increased Risk Of Infection
White blood cells can be lowered as a result of treatment. WBCs called neutrophils help fight infections. When neutrophils are low, this is called neutropenia and results in an increased risk of serious infection. Kids with cancer, especially those with neutropenia, have compromised immune systems and are not able to fight off bacteria and germs. A seasonal cold or virus that may not cause many symptoms in a healthy person can result in severe illness in a child receiving chemotherapy. Any fever can be a sign of serious infection and should be brought to the doctors attention immediately.
Some other signs of infection include:
Read Also: What Are The Abcdes Of Skin Cancer
You May Like: Symptoms Of Advanced Bladder Cancer
Effect On Daily Routine
Some people are able to go about their daily routine and keep working during chemotherapy as well as radiation therapy. The side effects, however, may require changes in schedule. Schedules may often need to be changed for treatment and hospital visits, but disruptions in daily life can be minimized by getting treatment late in the day or just before the weekend.
Practical Hints Regarding Neuropathy
- Tight shoes and socks can worsen pain and tingling, and may lead to sores that won’t heal. Wear soft, loose cotton socks and padded shoes.
- If you have burning pain, cool your feet or hands in cold, but not icy, water for 15 minutes twice a day.
- Massage your hands and feet, or have someone massage them for you, to improve circulation, stimulate nerves and temporarily relieve pain.
Don’t Miss: How Does Radiation Kill You
Hypofractionated Vs Traditional Radiation Therapy
In March 2018, the American Society for Radiation Oncology released updated guidelines on whole-breast radiation therapy saying that most people diagnosed with breast cancer should be treated with a hypofractionated radiation schedule.
In many cases, people diagnosed with early-stage breast cancer have radiation therapy after surgery to remove the cancer. Radiation therapy lowers the risk of the cancer coming back .
Whole-breast radiation therapy after breast cancer surgery is usually given as one treatment per day, 5 days a week, for 5 to 7 weeks. A Gray is the way radiation oncologists measure the dose of radiation therapy if youre on a 5-week treatment schedule, 50 Gy is the usual amount given during the 5 weeks . A supplemental boost dose may be included at the end of the regimen that targets the area where the cancer was.
Radiation treatment schedules were developed based on research results. But a 5- to 7-week nearly daily commitment may be difficult for some people, especially if they live far away from a treatment center. So doctors developed and studied different radiation therapy schedules that involve fewer treatments with higher doses of radiation at each treatment, but about the same total radiation dose. These hypofractionated radiation schedules put the same radiation dose into a 3- to 5-week schedule, instead of a 5- to 7-week schedule.