Cancer Treatment

What is 'pre-medication'?

Pre-medication is sometimes referred to in the medical literature as medication given prior to therapy, to alleviate the symptoms of the therapy, not necessarily the symptoms of the disease. So, in the past, I think chemotherapy got a very bad rap for causing projectile vomiting during the therapy, tremendous and horrible side effects during chemotherapy that really impacted the ability to provide therapy to patients. And it definitely impacts patients' anxiety when they start having the opportunity, or when they are unfortunately given the opportunity, to receive chemotherapy.

What is 'interferon therapy'?

Interferons are a normal part of your immune system and interferons are a target or at least an option for certain therapies of certain diseases and I think the most common disease that we use interferons for are melanomas. Metastatic melanoma or the melanoma or skin cancer. The reason why we use interferons is that it has been shown that enhancing the immune system is effective in at least trying to attack the existence of metastatic melanoma or melanoma that has been advanced in the body. And the use of interferons in order to boost the immune system has been utilized for this disease. It's not a very well tolerated treatment it actually leads to enhanced production of fevers, body aches, lots of symptoms that most patients can not tolerate. So it's not a treatment that I see as gaining a lot of popularity and I believe that there are other more novel agents that are out there to enhance the immune system that will be third or fourth generation type interferons that will necessarily be able to or will be able to improve on that particular type of therapy.

What is 'gene therapy'?

Gene therapy aims at the true source of the problem: the genetic problem, the DNA defect. That is essentially what gene therapy is - trying to identify, "Well, what genetic derangement caused this tumor to occur? And fix that."

How does my doctor 'stage' my cancer?

Stage is a very important concept in cancer for several reasons. First of all the stage defines where the cancer is located. It is an important question for both your doctor and you. The reason stage is important is because it defines which treatments are recommended and it also helps you understand your prognosis. The main way we determine the stage is by doing imaging studies such as a cat scan which takes x-rays of the body and puts it into a three dimension representation by computer or a M.R.I. scan which does the same thing using a magnet rather than an x-ray or a pet scan. A pet scan uses glucose which has radio activity attached. It is infused into the body, cancer cells take up the sugar much faster than healthier tissues. By imaging the body after it has the radiated glucose you can see where cancer is active. Between those studies stage can be determined and then you can have a good discussion about treatment and prognosis.

What do the different stages of cancer mean?

In general, early stages such as stage I means that the cancer is confined to the organ that it started in. For example, in lung cancer a stage I cancer is small and in a single lobe of the lung. Stage II then is usually larger but still confined to the organ. And the lung cancer would still be in one lobe but the tumor would be larger. Stage III, in general, is what we call locally advanced disease, either with the very large tumors or involvement of the lymph nodes around the primary organ. Stage IV means that a cancer has spread, usually through the blood stream to other parts of the body.Your doctor cares about the staging because it really will influence which types of treatments are recommended. Some people can be treated only with surgery and have a great expectation of cure. Other patients will need surgery and then radiation therapy, and still others will need all three forms of cancer therapy, surgery, radiation and chemotherapy.