Before Treatment: Making Sense of Cancer Therapies

Proven approaches and new technology mean individualized treatment

Scientists continue to learn more about cancer’s biology and how it affects each patient. As they make new discoveries, they are able to refine existing treatments and develop new ones.


If the cancer has not spread, surgery may be used to remove the tumor and, depending on the pathology of the cancer, the surrounding tissue. In some cases, patients may be eligible for less invasive surgical options.

Types of Cancer Surgery:

Laparoscopic surgery requires one or more small incisions that allow a thin fiberoptic scope, called a laparoscope, and specially designed surgical instruments to be inserted into the body to remove the tumor. Disease-free survival and recurrence rates for many types of cancer seem to be about the same when laparoscopic surgery is compared with traditional open surgery but for very specific tumor types and situations. The main benefits are faster recovery times, shorter hospital stays and fewer complications.

Robotic surgery may have even more  benefits for some patients. As with laparoscopic surgery, the operation requires a few small incisions. But instead of holding the surgical instruments, the surgeon sits at a control panel and moves the instruments with the aid of precise robotic arms. In addition to prostatectomy (surgery to remove the prostate gland), robotic surgery can be used for hysterectomy to treat cervical and endometrial cancers, for gastric bypass and for mitral valve repair, as well as some bladder, throat, thyroid and kidney cancers, and is being investigated in other cancers.

Radiofrequency ablation, or RFA, is an outpatient procedure that utilizes heat delivered through a thin, needle-like probe inserted into the tumor to kill tumor cells. Cryoablation is a similar procedure that uses rapid freezing and thawing to kill the cancer cells.


Radiation therapy may be used alone to treat some cancers but is most often used in combination with other therapies to improve the cure rate following surgery. Radiation may also be used to allow less extensive surgery or to relieve side effects of advanced cancer. High doses of radiation may cause side effects after treatment, as well as late effects, such as secondary cancers. Newer specialized techniques target radiation more accurately to tumor sites to minimize these effects.

Types of Targeted Radiation Therapy:

Brachytherapy radiates the tumor directly by implanting radioactive seeds or wires into the body near the tumor. Brachytherapy is used in prostate, cervical and other cancers. Brachytherapy may also be used in breast cancer. Called partial breast irradiation (PBI), it is still considered experimental and is sometimes used for smaller lymph node-negative breast cancers.

Conformal radiation employs several weak beams of radiation originating from different angles that intersect to produce a concentrated high dose of radiation at the tumor site. Advanced conformal therapy, such as intensity-modulated radiation therapy (IMRT), uses multiple beams with varying intensity.

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