Choice of cancer treatment is influenced by several factors, including the specific characteristics of your cancer; your overall condition;

and whether the goal of treatment is to cure your cancer, keep your cancer from spreading, or to relieve the symptoms caused by cancer. Depending on these factors, you may receive one or more of the following: Surgery Chemotherapy Radiation therapy Hormonal therapy Targeted therapy Biological therapy One or more treatment modalities may be used to provide you with the most effective treatment. Increasingly, it is common to use several treatment modalities together (concurrently) or in sequence with the goal of preventing recurrence. This is referred to as multi-modality treatment of the cancer. Surgery Surgery is used to diagnose cancer, determine its stage, and to treat cancer. One common type of surgery that may be used to help with diagnosing cancer is a biopsy. A biopsy involves taking a tissue sample from the suspected cancer for examination by a specialist in a laboratory. A biopsy is often performed in the physician s office or in an outpatient surgery center. A positive biopsy indicates the presence of cancer; a negative biopsy may indicate that no cancer is present in the sample. When surgery is used for treatment, the cancer and some tissue adjacent to the cancer are typically removed. In addition to providing local treatment of the cancer, information gained during surgery is useful in predicting the likelihood of cancer recurrence and whether other treatment modalities will be necessary. Learn more about surgery. Chemotherapy Chemotherapy is any treatment involving the use of drugs to kill cancer cells. Cancer chemotherapy may consist of single drugs or combinations of drugs, and can be administered through a vein, injected into a body cavity, or delivered orally in the form of a pill. Chemotherapy is different from surgery or radiation therapy in that the cancer-fighting drugs circulate in the blood to parts of the body where the cancer may have spread and can kill or eliminate cancers cells at sites great distances from the original cancer. As a result, chemotherapy is considered a systemic treatment. More than half of all people diagnosed with cancer receive chemotherapy. For

millions of people who have cancers that respond well to chemotherapy, this approach helps treat their cancer effectively, enabling them to enjoy full, productive lives. Furthermore, many side effects once associated with chemotherapy are now easily prevented or controlled, allowing many people to work, travel, and participate in many of their other normal activities while receiving chemotherapy. Learn more about chemotherapy treatment and the management of side effects. Radiation Therapy Radiation therapy, or radiotherapy, uses high-energy rays to damage or kill cancer cells by preventing them from growing and dividing. Similar to surgery, radiation therapy is a local treatment used to eliminate or eradicate visible tumors. Radiation therapy is not typically useful in eradicating cancer cells that have already spread to other parts of the body. Radiation therapy may be externally or internally delivered. External radiation delivers high-energy rays directly to the tumor site from a machine outside the body. Internal radiation, or brachytherapy, involves the implantation of a small amount of radioactive material in or near the cancer. Radiation may be used to cure or control cancer, or to ease some of the symptoms caused by cancer. Sometimes radiation is used with other types of cancer treatment, such as chemotherapy and surgery, and sometimes it is used alone. For more information, go to Radiation Therapy. Hormonal Therapy Hormones are naturally occurring substances in the body that stimulate the growth of hormone sensitive tissues, such as the breast or prostate gland. When cancer arises in breast or prostate tissue, its growth and spread may be caused by the body s own hormones. Therefore, drugs that block hormone production or change the way hormones work, and/or removal of organs that secrete hormones, such as the ovaries or testicles, are ways of fighting cancer. Hormone therapy, similar to chemotherapy, is a systemic treatment in that it may affect cancer cells throughout the body. Targeted Therapy A targeted therapy is one that is designed to treat only the cancer cells and minimize damage to normal, healthy cells. Cancer treatments that target cancer cells may offer the advantage of reduced treatment-related side effects and improved outcomes. Conventional cancer treatments, such as chemotherapy and radiation therapy, cannot distinguish between cancer cells and healthy cells. Consequently, healthy cells are commonly damaged in the process of treating the cancer, which results in side effects. Chemotherapy damages rapidly dividing cells, a hallmark trait of cancer cells. In the process, healthy cells that are also rapidly dividing, such as blood cells

and the cells lining the mouth and GI tract are also damaged. Radiation therapy kills some healthy cells that are in the path of the radiation or near the cancer being treated. Newer radiation therapy techniques can reduce, but not eliminate this damage. Treatment-related damage to healthy cells leads to complications of treatment, or side effects. These side effects may be severe, reducing a patient's quality of life, compromising their ability to receive their full, prescribed treatment, and sometimes, limiting their chance for an optimal outcome from treatment. Biological Therapy Biological therapy is referred to by many terms, including immunologic therapy, immunotherapy, or biotherapy. Biological therapy is a type of treatment that uses the body s immune system to facilitate the killing of cancer cells. Types of biological therapy include interferon, interleukin, monoclonal antibodies, colony stimulating factors (cytokines), and vaccines. Personalized Cancer Care There is no longer a one-size-fits-all approach to cancer treatment. Even among patients with the same type of cancer, the behavior of the cancer and its response to treatment can vary widely. By exploring the reasons for this variation, researchers have begun to pave the way for more personalized cancer treatment. It is becoming increasingly clear that specific characteristics of cancer cells and cancer patients can have a profound impact on prognosis and treatment outcome. Although factoring these characteristics into treatment decisions makes cancer care more complex, it also offers the promise of improved outcomes. The idea of matching a particular treatment to a particular patient is not a new one. It has long been recognized, for example, that hormonal therapy for breast cancer is most likely to be effective when the breast cancer contains receptors for estrogen and/or progesterone. Testing for these receptors is part of the standard clinical work-up of breast cancer. What is new, however, is the pace at which researchers are identifying new tumor markers, new tests, and new and more targeted drugs that individualize cancer treatment. Tests now exist that can assess the likelihood of cancer recurrence, the likelihood of response to particular drugs, and the presence of specific cancer targets that can be attacked by new anti-cancer drugs that directly target individual cancer cells. Anti-inflammatory drugs 'can cut cancer risk'

Experts in the US have suggested that certain anti-inflammatory tablets could

potentially reduce the risk of developing breast cancer, after testing on mice indicated some efficacy. Research conducted by a team at the University of Colorado and recently printed in the science journal Nature found non-steroidal anti-inflammatory drugs (NSAIDs) may prevent postpartum tumours from forming. Once new mothers have stopped breastfeeding their young, milk-producing cells die off and are replaced with fat cells - thereby potentially leaving women more likely to contract the disease. "A mother's body is undergoing radical changes during this time," said investigator Dr Pepper Schedin. "We can't yet speak to the safety of these drugs for women diagnosed with or at risk for postpartum breast cancer." The study came after Tenovus associate director of research Dr Ian Lewis insisted that despite a steady improvement in survival rates, there is still a need to offer greater support to breast cancer sufferers.

New Cancer Treatment? Universal Donor Immune Cells One of the latest attempts to boost the body's defenses against cancer is called adoptive cell transfer, in which patients receive a therapeutic
ScienceDaily (July 26, 2011)

injection of their own immune cells. This therapy, currently tested in early clinical trials for melanoma and neuroblastoma, has its limitations: Removing immune cells from a patient and growing them outside the body for future re-injection is extremely expensive and not always technically feasible. Weizmann Institute scientists have now tested in mice a new form of adoptive cell transfer, which overcomes these limitations while enhancing the tumor-fighting ability of the transferred cells. The research, reported recently in Blood, was performed in the lab of Prof. Zelig Eshhar of the Institute's Immunology Department, by graduate student Assaf Marcus and lab technician Tova Waks. The new approach should be more readily applicable than existing adoptive cell transfer treatments because it relies on a donor pool of immune T cells that can be prepared in advance, rather than on the patient's own cells. Moreover, using a method pioneered by Prof. Eshhar more than two decades ago, these T cells are

outfitted with receptors that specifically seek out and identify the tumor, thereby promoting its destruction. In the study, the scientists first suppressed the immune system of mice with a relatively mild dose of radiation. They then administered a controlled dose of the modified donor T cells. The mild suppression temporarily prevented the donor T cells from being rejected by the recipient, but it didn't prevent the cells themselves from attacking the recipient's body, particularly the tumor. This approach was precisely what rendered the therapy so effective: The delay in the rejection of the donor T cells gave these cells sufficient opportunity to destroy the tumor. If this method works in humans as well as it did in mice, it could lead to an affordable cell transfer therapy for a wide variety of cancers. Such therapy would rely on an off-the-shelf pool of donor T cells equipped with receptors for zeroing in on different types of cancerous cells

CANCER CURE DISCOVERED? Leukocyte InFusion 100% Effective! Now Being Tried on Humans (RobertsReview, RI, USA) -- Scientists are about to embark on a precedent-setting human trial to determine whether a new cancer treatment called Leukocyte InFusion Therapy (LIFT) will be as effective in humans as it has proven to be in mice. Researchers at Wake Forest University's Baptist Medical Center will transfuse specific white blood cells, called granulocytes, from select donors, into patients with advanced cancers. A treatment using the same type cells from cancer-resistant mice has cured 100 percent of lab mice with advanced malignancies, according to Zheng Cui, Ph.D., lead researcher and associate professor of pathology. "In mice, we've been able to eradicate even highly aggressive forms of malignancy with extremely large tumors," Cui said. "Hopefully, we will see the same results in humans. Our laboratory studies indicate that this cancer-fighting ability (of granulocytes) is even stronger in healthy humans!" FDA-approved human trails will use white blood cells from healthy young people whose immune systems produce cells with the highest levels of cancer-fighting activity. The anti-tumor response primarily involves granulocytes of the innate human immune system, a system known for its powerful ability to fight off infections. Granulocytes account for up to 60 percent of total white blood cells in healthy humans, researchers say, and people can donate granulocytes through a process

called apheresis. It separates granulocytes and returns other blood components back to donors, whose systems quickly remanufacture replacement granulocytes. For the study, 500 potential local donors are being recruited who are 50 years old or younger and in good health. The 100 donors with the highest cancer-killing activity in their cells will be asked to donate white blood cells for the study. Twenty-two cancer patients with solid tumors that don't respond to conventional therapies will receive the donated cells. To find out how to participate in the trial, including how to donate granulocytes or receive the treatment, go to Wake Forest University Medical Center. Cancer-killing ability in these cells is highest during the summer, so researchers are hoping to find volunteers who can afford the therapy quickly. For additional information on how to find and participate in this and various other FDA approved trials of the newest cancer treatments, see the TrialsFinder link on this page. New Treatment Destroys Cancer Cells & Tumors (RobertsReview, RI, USA) -- Scientists at Katholieke Universiteit Leuven in Belgium, in collaboration with the Flemish biotech company, Thrombo-Genics, report the anti-cancer agent "anti-PLGF" not only treats tumors for which other therapies fail, but also enhances effectiveness of existing forms of chemotherapy -- all without side effects! The findings were published in the prestigious medical journal, CELL. How it works All living tissue is supplied with oxygen and nutrients via blood vessels. But tumors grow much more quickly than normal tissue and have a greater need for nutrients. This is why, at a certain stage, tumor cells produce growth factors that stimulate formation of additional blood vessels (called angiogenesis) to feed the tumor. When formation of blood vessels that feed tumor cells is blocked, the tumor starves to death due to the lack of oxygen and nutrients. Existing anti-angiogenesis drugs eliminate the most common angiogenesis growth factor but cause serious side effects. In addition the cancer compensates by producing other growth factors, so that the drugs lose their effect. For several years now, researchers have been experimenting with a new angiogenetic growth factor: the placental growth factor, or PLGF. PLGF only stimulates blood vessel formation in cancer and other diseases. Researcher Christian Fischer and his colleagues under the direction of Peter Carmeliet and in close collaboration with the biotech company ThromboGenics directed by Dsir Collen have been studying the therapeutic possibilities of anti-PLGF, which retards the action of PLGF. Anti-PLGF not only increases the effectiveness of chemotherapy and the current anti-angiogenesis therapy, but also

inhibits growth and metastasis of tumors resistant to existing drugs. In contrast to current therapies, anti-PLGF does not trigger a rescue operation in which other growth factors are produced as compensation. What's Next? Favorable evaluation of anti-PLGF as a potential cancer treatment raises hope for a more effective cancer therapy with fewer side effects which can be used with children and pregnant women, too. First clinical tests of the new treatment are expected to begin shortly. Via www.youtube.com/watch?v=_ZEysIhDsokyou can find a 3D animation which clearly shows the described research. Patients, researchers, and physicians may submit questions concerning this research via:patienteninfo@vib.be The research report appears in the journal,Cell (Fischer et al., Anti-PlGF inhibits growth of VEGF(R)- inhibitor resistant tumors without affecting healthy vessels). New Vaccines Reversing Melanoma, Leukemia, Lymphoma, Pancreatic, Prostate Cancer (RobertsReview, RI, USA) -- When retired surgeon, Dr. Eugene Overton, 74, was diagnosed with melanoma, instead of chemotherapy, which causes devastating side effects, he chose an immune system "booster shot" to fight the often deadly cancer.. He receives injections every three weeks that signal the his immune system to attack malignant cells, much as the body does with viruses and bacteria...only this time the target is cancer cells. And it is working! Overton boasts he's not only had no recurrence of melanoma, but also no side-effects from the treatment. This is because immunotherapy doesn't damage healthy tissue the way chemotherapy and radiation do.. About 160 immunotherapy approved "trials" are under way in the U.S., some are on the verging of going for FDA approval. Leading the way is the University of Texas M.D. Anderson Cancer Center, which three years ago opened a state-of-the-art immunology research center. One high-profile success is keeping an M.D. Anderson doctor healthy and thriving nearly 15 months after he was diagnosed with glioblastoma, a deadly brain cancer he treats that typically kills its victims well within that time.

Even though prostate and brain cancers are being treated successfully with the approach, the greatest promise involves blood and microscopic cancers. "It's the first time I've seen usually jaded oncologists excited about the prospects with immunotherapy," Dr. Amy Heimberger, an M.D. Anderson neurosurgeon says. "Suddenly, senior doctors who once pooh-poohed immunotherapy are referring patients to junior researchers in the field." Oddly, the treatment dates back to 1891 when New York doctor William Coley inoculated cancer patients with live streptococcal cultures and some experienced remissions. The shot fell by the wayside due to inconsistent results and the growing dominance of surgery, radiation and chemotherapy. Now, however, researchers have identified "markers" unique to cancer cells that the immune system can be trained to target. They've also discovered naturally occurring, immune system-boosting compounds that can be produced in labs. The result is a new, one-two punch of drugs that energize the immune system and direct it to go after specific cancer cells that it had hardly noticed before. Dr. Jeff Molldrem, an M.D. Anderson professor of blood and marrow transplantation says, "It's like suddenly having the cancer's postal address and being able to activate the immune system to deliver its blow there." One M.D. Anderson treatment produced complete responses in a clinical trial for patients with acute leukemia for which no other intervention had been successful. Another showed that glioblastoma patients survived significantly longer than those treated with current chemo and radiation therapy...and with very few side effects. The Mary Crowley Medical Research Center in Dallas produced responses sometimes years-long remission in half of trial participants with a lung cancer that typically kills within four to six months. At the National Cancer Institute, a mix of cancer-specific T cells and a booster produced unheard-of improvement in patients with advanced melanoma. Johns Hopkins is working on pancreatic cancer, which kills 31,000 Americans annually. To battle it, JH researchers are supplementing surgery, chemotherapy, and radiation with a new vaccine that uses stunted cancer cells that emit a molecule called GM-CSF. It attracts cells that still have immunity to the tumor and causes these cells to come

in contact with antigens from cells that have been exposed to radiation. These same cells then travel around the body and annihilate other cancer cells. Patients receive the vaccination eight to 10 weeks after surgery and again after chemotherapy and radiation. Two years into the study, results are optimistic: Survival rates for the 60 patients in the study are reported to be 88 percent after one year and 76 percent after two years for the rapidly deadly form of cancer, which is the fourth leading cause of death in the United States. Dr. Daniel Laheru, who heads the study, says the only known cure for pancreatic cancer is surgical removal of the cancer. The setback, he explains, is that only 15 to 20 of every 100 patients can have the surgery because this type of cancer is often not detected early enough. Survival rates, especially in the long-term, were grim under traditional approaches...until now. Interestingly, immunotherapy sometimes works even better when combined with chemotherapy or radiation, which suppress the immune system! For instance, an M.D. Anderson study recently found immunotherapy helped fight an aggressive form of lymphoma, even though prior chemotherapy had obliterated all the B cells thought necessary to mount an immune defense! Despite endorsements, a lack of randomized trials in support of the therapy continues to exist. Nevertheless researchers say the greatest strides are being made against cancers where the immune system can fight them in manageable stages, such as in the blood or lymph nodes or in early diagnosis. Late stage tumors, they say, can be attacked, too, but winning the battle against them is more difficult.
Experts Clash On Efficacy of New Brain Cancer Treatment (RobertsReview, RI, USA) Children with high-risk medulloblastoma have had only a 30-40 percent chance of surviving to five years. Now, however, a new experimental treatment that relies on a child's own stem cells dramatically improves the odds. "We can now cure about 70 percent of children with high-risk medulloblastoma and more than 80 percent of those with standard-risk disease with a much shorter chemotherapy approach," said lead researcher Dr. Amar Gajjar, from St Jude's Children's Research Hospital in Memphis, TN. In Sept. 7 online edition of medical journal The Lancet Oncology doctors described the new

treatment in which radiation therapy is tailored to fit the severity of the brain cancer. It is then followed by a dramatically reduced course of chemo. To accomplish the reduction researchers took stem cells from patients before chemotherapy and implanted them after each round of chemo. Researchers report that this allows the chid's body to recover from the extensive damage caused by chemo. Use of (chemotherapy drug) cisplatin was reduced from eight doses to four doses, and the amount of vincristine from 32 doses to just eight! This alleviated much of the neurotoxicity associated with the normal chemo dosages. Gujjar says, "investigators should consider adopting a similar therapeutic strategy for high-risk patients. This approach should be feasible in most pediatric oncology units at academic medical centers, but meticulous staging and careful attention to detail during radiotherapy planning and treatment are essential to obtain similar results." But Dr. Anna J. Janss, co-director of the Neuro-Oncology Program at the Aflac Cancer Center of Children's Healthcare of Atlanta -- said the findings won't change her approach to treating childhood brain cancer. Dr Janss says the results don't make her say: "Oh, I want to treat all my patients this way." She said the new approach is only as good as what has been done before, but not good enough to make her harvest stem cells from every child she treats.

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