化疗进展
Dr. 弗雷德里克•米. Briccetti joined NH Oncology-Hematology 29 years ago and has been the Medical Director for the Payson Center for Cancer Care for two years. 康科德医院庆祝成立20周年th 佩森皇冠app中心成立周年纪念. Briccetti shares the advances in treatment and testing that have occurred over the past two decades.
How have oncology treatment options for people with cancer evolved over the past 20 years?
二十年Top, medical oncology treatment options consisted of chemotherapy and hormonal therapy along with a few immune therapies. 现在有更多的选择. 皇冠app仍然提供化疗和激素治疗, 但现在有了更具体的治疗方法, which target the molecular drivers of cancer and also ones that help stimulate the immune system to fight cancer.
Advances in testing have had a major impact on determining an appropriate treatment plan. 例如, the Oncotype DX test can help us eliminate chemotherapy treatment for many patients with early-stage estrogen receptor-positive breast cancer. This test evaluates the genes that are present in an individual woman’s tumor to predict the risk of recurrence and the need for adding chemotherapy to hormonal treatment. 另一个突破性测试, 下一代DNA测序, 评估存在于许多其他癌症类型细胞中的基因, in order to identify potential therapies targeted to their particular tumor’s genetics.
What are some advances in treatment options that have emerged?
The two biggest advances in treatment have been biologic–targeted therapy and immunotherapy. Biologic therapy involves using medications – often pills – that are targeted at specific mutations that are driving the cancer. Immunotherapy stimulates the immune system to recognize and attack cancer. We use these agents to treat many cancer types either alone or in combination with chemotherapy.
What types of treatment are offered at the Payson Center for Cancer Care?
皇冠app可以治疗大多数类型和阶段的癌症患者. We have a wonderful assortment of expert surgical colleagues and many patients with cancer who first receive surgery for their problem and are then referred to us. 作为医学肿瘤学家, 皇冠app使用荷尔蒙疗法, 化疗, 靶向治疗和免疫治疗.
这取决于癌症的类型, some people are better off receiving treatment at a large cancer center, 皇冠app很幸运，在皇冠app的地区有一个选择. We have good relationships with many of them with whom we share the care of our patients.
Are there types of cancer that can only be treated using chemotherapy?
根据癌症的扩散程度, people with most types of cancer will receive some form of systemic therapy. 有时只需要化疗. 其他治疗方法, 皇冠app使用不同的药剂, 包括激素疗法, targeted therapy or immunotherapy or a combination of these.
We have learned over the years that there are some types of cancers in certain stages that respond better to treatment if given a combination of both radiation therapy and chemotherapy, 加上或减去免疫疗法. 例如, 对于某些阶段的头痛患者的标准治疗, 脖子, 口, 喉, 扁桃体癌或舌癌将接受这种组合. Individuals with stage three lung cancer often receive chemotherapy and radiation together, 然后是免疫疗法.
人们也可以接受一系列的治疗, 比如那些患有II期或III期乳腺癌的人, 哪些人可以接受手术治疗, 然后是化疗, 然后辐射.
Have the side effects from chemotherapy improved over the years?
There has been significant progress achieved with easing the immediate and delayed side effects of chemotherapy. Immediate nausea is treated using intravenous therapies given just before chemotherapy, 而药, 在家拍摄, 是否用于治疗延迟性恶心.
有趣的是, a common medicine used to treat schizophrenia called Olanzapine was found, 几年Top, 对恶心有不可思议的抑制作用. It is now prescribed to patients routinely, in an effort to minimize nausea and vomiting.
What types of cancer services are not offered at the Payson Center?
The Payson Center for Cancer Care does not treat pediatric cancer. It is evident from multiple studies that this type of cancer is best managed at a larger cancer center, such as Dart口-Hitchcock Medical Center or Boston Children’s Hospital.
研究表明，年轻人, medically fit people with acute leukemia treatment are better off receiving treatment at a large cancer center. They require highly specialized and trained staff to treat this form of cancer. 除了, the frequent transfusion needs of these patients outstrip the capacity of community hospital blood banks. 病人 who require certain kinds of specialized surgery or who have certain cancer types, 比如肉瘤, 在大型癌症中心接受治疗是不是更好.
Other types of treatment that are not provided at the Center include, 干细胞移植, (from the patient themselves or from another person) and chimeric antigen receptor (CAR-T) treatment, which is another common form of immune therapy used to treat lymphomas and some leukemias. The Payson Center for Cancer Care has close relationships with the large cancer centers in our area to help facilitate these treatments for patients.
What will the focus be in the future on cancer treatment options?
Molecular medicine will continue to revolutionize advances in cancer treatment. NH Oncology-Hematology has an active clinical research program, which has helped in the effort to enhance treatment options for patients over the years.
Another focus for the future of cancer treatment is human genetics. Using a blood test or by taking cells in the inside of the cheek, 皇冠app可以检查一个人的基因, looking for abnormal genes that may put them or their family at an increased risk for cancer. 皇冠app学校有一个非常活跃的遗传学诊所, through a corroborative agreement with Dana-Farber Cancer Institute.
