How do I decide what kind of cancer treatment to pursue?

How do I decide what kind of cancer treatment to pursue?

Steven Brower, MD, Vice-Chairman, Department of Surgery and Chief, Division of Surgical Oncology, Mount Sinai Beth Israel

A. A majority — 70 to 90 percent — of cancer patients will begin treatment with some form of diagnostic surgery, whether it’s a biopsy or a more extensive exploratory surgery to confirm diagnosis and staging, says Dr. Steven Brower, Chief of Surgical Oncology at Mount Sinai Beth Israel. “After a diagnosis, it is determined whether an individual might require additional surgery, chemotherapy, radiation therapy, biologic therapy or a combination of those therapies,” he says.  

  • Surgery has many functions. It may be required to help diagnose and stage a cancer, remove all or part of a tumor, or to remove tissue or organs that have a high risk of developing cancer. Many cancer surgeries use minimally invasive techniques, which help speed recovery and minimize scarring.
  • Chemotherapy is a systemic treatment — meaning, it travels throughout the body — that uses chemical substances to slow or stop the growth of cancer cells. Chemotherapy is introduced into a muscle, body cavity or the vascular system, applied to the skin, or taken by mouth.
  • Radiation therapy sends doses of high-energy particles, like X-rays and gamma rays, to destroy or damage cancer cells. This treatment is very localized, targeting a specific area, so it does little harm to nearby tissue.
  • Biologic therapy involves the use of living organisms, substances derived from living organisms, or synthetic versions of those substances. These substances, which include vaccines, gene therapy, and antibodies, stimulate the body’s immune system to act against cancer cells.

Q. Will I get a new doctor?

 A. “The most common treatments include an opinion of multiple specialists. We call that multi-disciplinary cancer opinion,” Dr. Brower says. Cases are presented at various disease management teams or tumor boards with experts from surgery, radiation oncology, medical oncology and cancer support services like psychiatry and social work. That team helps the patient decide on a treatment plan that is right for him or her.

Q. Should I get a second opinion?

A. Any patient with a cancer diagnosis deserves and should consider getting a second opinion, Dr. Brower says. “We want patients to be comfortable with the recommendation provided by the doctor or cancer team, and a second opinion often makes a family and a patient much more confident,” he says. Patients should also seek out information and educational resources from the National Cancer Institute, where many research trials are underway, and the American Cancer Society.

Q. Should I join a support group?

A. Every major cancer program will provide support groups for patients who have been recently diagnosed, are undergoing treatment or have survived cancer. “Survivorship is such an important component of support groups because more patients are living longer,” Dr. Brower says. “We need to recognize what it means for a patient to survive cancer and to chart a course with them about follow-up and options for moving forward.”

Q. How has cancer treatment evolved in recent years?

A. Most patients are treated in cancer programs accredited by The American College of Surgeons’ Commission on Cancer. Mount Sinai Beth Israel’s cancer program is accredited as a network cancer program with the Continuum Cancer Centers of New York, meaning all hospitals have the highest level of accreditation, Dr. Brower says. The program prioritizes all three phases of cancer care: prevention and screening, treatment, and survivorship.

“Over the last decade, we’ve seen remarkable advances in cancer treatment for both solid tumors and malignancies of the blood like leukemia and lymphoma,” Dr. Brower says. “There has been a lot of progress and a focus on personalized cancer medicine, basing treatments on the patient’s unique genetic profiles and the cell biology of their cancer. We want to look at each patient individually and get them the right treatment so they can become a survivor.”

To learn more about cancer treatment options at Mount Sinai Beth Israel, call 1-855-411-LWNY (5969) or visit its website.

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