Cancer Treatment Types: What Do They All Mean?

When you or a loved one is facing a diagnosis of cancer, it can feel overwhelming. Suddenly there are treatment decisions to be made and questions about everything—from what to expect, to how to manage the logistics of daily living.

At the Ann B. Barshinger Cancer Institute, we encourage patients and families to ask questions. The more you understand about your condition and today’s cancer treatment options, the better prepared you will be to make informed choices and participate in your care plan. You’ll be supported by a specialized cancer physician who leads an experienced team, that includes personal nurse navigator, to help guide you, answer questions, and support your decision-making to fit your individual situation and your individual preferences. 

Your doctors will explain and recommend the most up to date therapies for your specific condition. Treatment options include:

Chemotherapy

Chemotherapy drugs to attack cancer cells and stop them from growing and multiplying. A medical oncology physician oversees chemotherapy and determines if it is best used alone or in conjunction with surgery, radiation therapy or other treatments. Depending on your type of cancer and its stage of development, chemotherapy may be used to cure cancer, decrease the size of a tumor, prevent the spread of cancer cells to other areas of the body, eliminate cancer cells that have spread (metastasized), or even relieve some symptoms caused by cancer.

There are a variety of chemotherapy drugs, including new options available through clinical trials. Chemotherapy may be administered orally (in pill or capsule form); injected into a vein, muscle or skin; or delivered directly via catheter to a specific area of the body. Side effects from chemotherapy treatments vary. We provide personal education, careful follow up, 24 hour telephone availability and a number of therapies and services that can minimize and alleviate symptoms. We support your physical and mental health while undergoing treatment.

Surgery 

Once cancer has been diagnosed, surgery may be recommended to remove tumors; assist with other types of treatment, such as placement of a port for chemotherapy; or reconstruct areas of the body affected by other surgeries, such as breast reconstruction after mastectomy.

Surgical techniques in the treatment of cancer are extremely advanced, allowing surgeons to perform highly complex procedures with precision and safety. Depending on your type and location of cancer, our surgeons may recommend a minimally invasive or robotic approach, that leads to  faster recovery and fewer complications than traditional approaches; laser surgery that utilizes extreme cold (cryosurgery) or heat to destroy abnormal cells; plastic surgery to restore the appearance or function of body parts following tumor removal; videoscopic techniques such as endoscopy and laparoscopy that use tiny fiberoptic cameras attached to thin, flexible tubes to generate images from inside the body; and more.

Radiation Therapy

Radiation therapy uses high-energy radiation from X-rays, protons, gamma rays and other energy sources to destroy cancer cells. Radiation can be external (coming from machines outside the body) or internal (delivered by radioactive material placed in or near tumors in the body). Radiation therapy works by damaging the DNA inside cancer cells so they are unable to grow and divide. Though radiation may affect nearby healthy cells, healthy cells can repair the damage. Today’s technology is highly sophisticated and allows for treatment that precisely targets the cancer while reducing exposure to healthy tissues.

Radiation may be recommended by itself or in combination with chemotherapy or other treatments. Radiation can be used to shrink a tumor before surgery, or after surgery to destroy any remaining cancer cells and help prevent recurrence. A radiation oncologist (cancer doctor specializing in radiation therapy) leads an experienced team to deliver the treatment most effectively. In addition to standard therapies, our clinical research trials offer eligible patients the latest treatment options before they are widely available.

Bone Marrow and Stem Cell Transplantation 

Bone marrow is a soft, sponge-like material inside your bones. It contains the stem cells that make the cells that carry oxygen through the body, fight infection, and help blood clot, which protects you from bleeding. Bone marrow and stem cell transplant are procedures that collect and restore stem cells that have been destroyed by high doses of chemotherapy and/or radiation therapy. The main purpose of stem cell transplant in cancer treatment is to make it possible for patients to receive very high doses of chemotherapy and/or radiation therapy. 

As Penn Medicine, we have one of the oldest and largest bone marrow and stem cell transplant programs in the country, at Penn Medicine's Abramson Cancer Center in Philadelphia. It is the only such program in the region and doctors at Ann B. Barshinger Cancer Institute oversee and coordinate care joint care when needed in leukemia, lymphoma, multiple myeloma, or myelodysplasia.

Hormone Therapy 

Hormones that naturally occur in the body—such as estrogen, progesterone and testosterone — can stimulate or suppress the growth of certain types of breast and prostate cancers. When hormones are used as cancer treatment, they block the production or effects of natural hormones to help prevent cancer from growing or recurring. Surgery may also be recommended to remove ovaries or testicles, in order to stop hormone production.

Immunotherapy

Immunotherapy is a type of treatment that harnesses the body’s own immune system to fight cancer cells. This may be accomplished by programming the immune system to identify and attack undetected cancer cells, or by boosting the body’s immune response with medication. Immunotherapy is a cutting-edge treatment and Penn Medicine is at the forefront of research. Our health system is a national leader in immunotherapy.

Types of immunotherapy include:

• CAR-T cell therapy, the first FDA-approved immunotherapy of its kind for patients with acute lymphoblastic leukemia, non-Hodgkin lymphoma, and multiple myeloma. It was developed at Penn Medicine and is currently being tested for other forms of cancer as well. CAR-T cell therapy involves extracting T cells (infection-fighting white cells) from the patient’s body, re-engineering those cells to target and kill cancer cells, and infusing the treated cells back into the patient’s body through an IV. This advanced therapy will be available at the Ann B. Barshinger Cancer Institute beginning in 2022.
• Targeted molecular therapy uses drugs to disable cancer cells, which allows the immune system to destroy them. It has been used to treat melanoma and lung cancer, and is being tested in other cancers, including ovarian.
• Vaccine therapy is used to treat a variety of cancers and works by stimulating the immune system so it recognizes cancer cells as foreign and attacks the cells. Cancer vaccines are sometimes made with cells from the patient's own tumor, which are modified in the lab and then injected into the patient to stop, destroy or slow the growth of the cancer.

Proton Therapy 

Proton therapy is a painless, noninvasive type of advanced radiation therapy that uses high-energy protons (positively charged atoms) to damage the DNA in cancer cells, prevent them from multiplying, and destroy them. Because proton beams can be contoured to the exact shape and location of the tumor, proton therapy is highly accurate and targets only the cancer. This make it a good option for treating cancers that are close to critical areas such as the brain or heart.

Proton beams emit low energy when entering the body, and they deposit very little radiation when exiting the body. That means less radiation exposure to nearby healthy tissue, reducing your risk of side effects. Penn Medicine’s Roberts Proton Therapy Center in Philadelphia is a global leader in proton therapy, extending proton therapy expertise to the Ann B. Barshinger Cancer Institute.

The Proton Therapy Center at the Ann B. Barshinger Institute is the first and only proton therapy center in Central PA.

Photodynamic Therapy

This treatment combines light-sensitive medication and low-level laser beams (light) to destroy cancer cells. Also called photoradiation therapy, phototherapy and photochemotherapy, it works by injecting a substance into the bloodstream that accumulates in cancer cells. When a laser is placed close to the treated cancer cells, the photosensitizing agent absorbs the light and produces an active form of oxygen that destroys the cancer cells. The light can be administered through a bronchoscope for some lung or esophageal cancers, directed at cancers just under the skin such as head and neck cancers, or under the lining of organs like stomach cancer. Penn Medicine was the first in its region to offer photodynamic therapy.

Comprehensive Services

In addition to a variety of cancer treatment options, the Ann B. Barshinger Cancer Institute, offer our patients and their families direct access to supportive services and clinical trials.

• Supportive or Integrative Services—Holistic therapies such as Reiki (which uses gentle touch), aromatherapy, acupuncture, massage, yoga, guided or mindfulness meditation, and art therapy may promote healing and recovery that help patients regain an overall sense of well-being during and after cancer treatments. In addition, patients may benefit from programs to help manage pain, treatment side effects, nutritional needs, mental and emotional health, and concerns related to appearance.
• Cancer Clinical Trials—Patients who participate in clinical trials, or studies, have the opportunity to receive groundbreaking new medications or other therapies that are not yet widely available. Placebos are never used in place of treatment; patients in studies receive either the best treatment currently available for their specific cancer or a new and possibly more effective therapy. Studies adhere to strict safety regulations and the cost of treatment may be covered by the study. Ask your care team if there are open trials for which you or a loved one may be eligible here in Lancaster or at another Penn Medicine location.