Whether or not cancer is curable – This question has been asked many times. Yes, the answer is YES! More than two-thirds of cancers are curable if caught early and treated properly. Cancer recurrence is extremely unlikely in people who have been successfully treated for it and it does not recur within the next five years.
Cancer cure is determined by three factors: the type of cancer, the stage at diagnosis, and the effectiveness of the treatment. There is a better chance of survival if the disease is detected early. Because of advances in cancer biology and cancer prevention and treatment, two-thirds of people now live for at least five years after a cancer diagnosis. However, there are still challenges to overcome, such as early cancer detection, making treatment available to everyone, and searching for new ways to treat resistant cancers.
Curing cancer at any cost is no longer tolerated casually. More than ever before, the return to a productive and useful lifestyle following cancer treatment is valued. For the past two decades, the concept of organ preservation has been at the forefront of modern cancer care. Preservation of organ form and function is now the standard of care in many cancers, including breast, larynx, rectum, anal canal, bladder, and limb sarcomas. Organ conservation approaches must have a high likelihood of eradicating the tumor, be low risk of recurrence, and not compromise organ form and function.
Consider the following cases where organ preservation strategies have made a significant difference in the patient’s quality of life:
Cancers of the Throat (Larynx and Pharynx) – Traditionally, throat cancers were treated with a total laryngectomy (removal of the voice box) and radiotherapy, either alone or in combination. This radical surgery results in a loss of speech as well as compromised respiration and swallowing functions. Significant technological advances in radiation delivery, the availability of effective chemotherapy drugs, and voice rehabilitation have shifted the emphasis to ‘Organ Preservation.’ Co-administration of cancer chemotherapy and radiotherapy in properly selected patients has resulted in reasonable tumor control rates, organ preservation, and patient quality of life.
Breast Cancer
Mastectomy, or complete removal of the breast and surrounding tissues, has traditionally been the standard surgery for patients diagnosed with breast cancer. This procedure not only limits arm movement but also has a significant psychological impact on the patient. Breast loss has a significant impact on the quality of life of breast cancer patients. Mastectomy has been replaced by Breast Conservation surgery, which removes only the tumor-bearing area and a rim of adjacent normal tissue with acceptable cosmesis due to a better understanding of tumor behavior and technological advancements. This technique has demonstrated comparable tumor control rates and is now widely used in the treatment of breast cancer.
Cystectomy,
or removal of the urinary bladder with an artificial urine passage through the abdominal wall, is the standard of care for muscle-invading bladder cancers. Advances in radiation planning and delivery techniques, as well as the availability of less toxic chemotherapy drugs, have led to the development of bladder-preserving approaches in carefully selected patients.
Rectal Cancer
When determining the treatment protocol for rectal cancers, the functional outcomes are given careful consideration. The restoration of bowel function and anal continence are the issues that are prioritized. In recent years, the use of pre-operative chemo-radiation protocols has resulted in tumor downstaging, improved resectability, and anal sphincter preservation, all of which have a significant impact on patient’s quality of life.
Anal Cancer
The traditional approach to treating anal cancers involved the removal of the anal sphincter and the placement of a permanent bag on the abdominal wall to allow stools to pass. Chemo-radiation has become the standard of care over the last three decades, preserving the anal sphincter and eliminating the need for a permanent stoma.
Soft Tissue
Bone Sarcoma of Limbs – In these cancers, the traditional approach of amputation dealt a significant blow to the patient’s quality of life. Limb preservation protocols have become more common as surgical techniques, rehabilitation services, and effective chemotherapy drugs have advanced and refined.
Organ preservation protocols have been developed through multidisciplinary collaborative approaches with knowledge and respect for the benefits and shortcomings of individual treatment modalities. More efforts are being made to improve cancer patients’ quality of life and provide acceptable cure rates.