Christer Sundqvist

Typical cancer drugs are chemotherapic agents (cytostatics), which intend to destroy the malignant cells. Cytostatic agents inhibit cell division and thus cause cell death. Cancer medications can be given to reduce or destroy an existing tumor and to counteract a malignant tumor.

Cytostatic agents affect all cells, even the healthy tissue is being hit. However, cancer cells often divide much faster than normal cells, making cancer cells particularly susceptible to cytostatics. In healthy cells, the effect of the cellular toxins becomes smaller, and healthy cells also recover more quickly from the treatment. Cellular toxins have somewhat less significance in cancer care since new biological drug treatments have been developed. However, cytostatics are still widely used.

Different types of chemotherapy are used in the treatment of cancer, which gives its effect in different ways. The most common is a combination treatment of several different chemotherapeutic agents. The effect of chemotherapy is dependent on the tumor type, the size of the tumor, the growth rate of the cancer and the proportion of active cell divisions in the cancer cells.

Cytostatic agents can be given in tablet form or in the form of drops directly into the blood vessel. Sometimes the drug is given locally, for example, into the pleura, bladder or spinal canal. Intravenous treatment is usually given in a hospital, but the patient can return home after treatment.

Treatment with chemotherapy is usually given every 3-4 weeks. This does not allow the cancer cells time to recover, but the healthy tissue gets its much needed break. Chemotherapy requires careful monitoring of blood counts.

Cytostatic agents cause side effects. Usual side effects are general nausea, hair loss and fatigue. Side effects vary individually. Some side effects will disappear in a few days, but the patient will usually recover completely from chemotherapy after a few months.

Nowadays, medicines are also given in the form of hormones. These can be called precision drugs. The effect of the hormonally given cancer treatment is based on the principle of preventing the production or effects of an important hormone of the tumor. Hormonal cancer treatment is used, for example, in the treatment of breast cancer, prostate cancer, thyroid cancer and uterine cancer. The hormones strongly regulate the normal growth and development of the above mentioned organs.

Hormonal treatments are well tolerated compared to cytostatics. Hormone therapy is usually a long-term treatment method, where treatment is usually given for many years. Sometimes the hormone treatment can continue for the rest of the patient’s life.

The new biological drugs against cancer are precision drugs targeted at the cancer tumor. Precision drugs are anticancer vascular growth drugs, antibodies and drugs that inhibit the activity of a particular gene in a cancer cell. These are unfortunately expensive drugs.

Biological precision drugs often give the advantage that the side effects are less than that of cytostatics or radiotherapy because the drug only affects the cancer cells. Precision drugs, such as antibodies, are becoming increasingly common in the treatment of cancer. The effects of these biological drugs are related to certain specific cell structures and functional disorders in certain types of tumors.

Immunological cancer therapy (immunotherapy) is a variety of cancer treatment methods that attempt to disrupt the defense systems of the cancer cells in various ways. Here the goal is to improve the body’s immune system and thereby give the body’s own immune defense system better chances in the fight against the cancer cells. In immunotherapy, the patient can also be given cytotoxic drugs or other drugs that interfere with the growth of cancer cells. There is currently a lot of development in the area and there is a lot of research on immunological cancer treatments.

Antibody treatments have been the subject of active research over the past few decades. Antibodies work in many ways in the treatment of cancer. Antibodies specifically developed against cancerous tissue can be bound to markers (antigens) on the surface of the cancerous tissue. Thus, the cancer cells are marked for their own immune system, which can then destroy the cancer cells. The Nobel Prize in Medicine was awarded in 2018 to the development of immunotherapy and antibodies.

Antibodies can prevent the effect of various growth factors for the tumor. Antibodies can also be used to transport into the cancer cell various chemotherapy (cytostatics or radiation effects), thereby reducing the drawbacks of the growth of healthy cells. Many antibody treatments are well tolerated. The most common side effects are fever, chills and rashes.

Newer, more effective drugs have largely eliminated the traditional interferons. Interferons are proteins that act as hormones. The body’s own cells produce interferon. Interferons have been used to treat certain cancers, either alone or in combination with other anti-cancer drugs. The treatment period is usually several months, often is needed a period of several years. Interferon treatments have been used, for example, in the treatment of lymphoma and melanoma. Interferon is an immunological treatment of cancer, which aims to destroy cancer cells by affecting the body’s own defense mechanisms. Side effects caused by interferon therapy are flu-like symptoms and fever. The side effects can vary greatly.

Cancer medication is often given as combination therapy. With this you want to make the patient’s chances of being cured as well as possible.

Medication can also be given in advance as prophylactic treatment or supplemented with surgical treatment. Adjuvant (supplemental) treatment means that the treatment is supplemented with anti-cancer drugs, precision drugs or hormonal drugs. It is also intended to destroy small, invisible metastases that may still exist after surgery or radiation therapy. This treatment has improved the prognosis for many cancers and is also considered to be one of the main reasons for the improvement of the prognosis in cancer patients.

Often, it is necessary to supplement drugs with specific support measures, for example to alleviate the symptoms that cancer treatments give rise to. The support measure can help improve the patient’s quality of life during and after treatment. For example, drugs for nausea are useful for patients receiving chemotherapy as a cancer treatment. Treatment of cancer pain is also a cancer treatment.

The goal of the symptomatic treatment (palliative care) is to alleviate the patient’s physical and mental symptoms and improve the patient’s quality of life. Many symptomatic treatments are often given, for example, to relieve these symptoms: pain, constipation, nausea, confusion and fatigue.

If cancer cannot be cured, the focus will be on treating the patient’s symptoms so that the patient can live as good a life as possible. Symptomatic treatment is of central importance to people with cancer. The methods of the symptomatic treatment may be partly the same as in the primary therapy. Radiation therapy, for example, can reduce the metastases, which makes the patient’s condition better. In addition to the physical symptoms, the aim is to relieve the patient’s mental symptoms, such as the fear of death and anxiety.

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