Treatment for Neoplasia

  • Surgery: cutting out the neoplasm is still the most effective treatment method, but not all primary sites are accessible or resectable with a clear margin. Once metastasis has occurred, surgery is no longer primary curative therapy.

  • Radiation: effectiveness depends upon the radiosensitivity of the tumor and the body's ability to tolerate the radiation dose without serious sequela from necrosis, fibrosis, or radiation sickness.

  • Chemotherapy: effectiveness depends upon the ability of the drug(s) to selectively poison the neoplastic cells and not normal cells. Combination chemotherapy (multiple drugs) allows treatment with lower doses of each drug with potentially less tumor resistance. Some neoplasms can be influenced by hormonal therapy (estrogens inhibit prostatic adenocarcinoma, antiestrogen therapy inhibits breast adenocarcinoma).

  • Biotherapy: develop a monoclonal antibody directed at protein targets within tumor cells. A monoclonal antibody directed at HER2 protein, an epidermal growth factor receptor expressed only by breast cancer cells, is highly specific.

  • Immunotherapy: either tries to promote the body's own immune surveillance (activating T lymphocytes) or tries to direct antibodies against tumor antigens.

  • Physical agents: hyperthermia and cryotherapy attempt to selectively kill more thermally sensitive neoplastic cells.

The problem with all treatments other than surgery is that they are never 100% selective for the neoplastic cells, and some normal cells may be injured.

Patients with a positive attitude or who have something to live for and have emotional support from family, friends, or a caring physician will tend to do better with treatment and/or live longer.