Medical Chinese(IV) Cancer Therapies






Cancer is extremely dangerous and cunning, but we have increasing number of ways of cancer treatment, which are more and more effective. Therefore, for the treatment of cancer we must choose among the various therapies, in order to formulate the best, most comprehensive and most effective treatment plan. Based on my own experience, JYang holds the idea that the key to cancer patients' hopes for life lies in sufficient information.



JYang will now try to list the various cancer therapies.

一.化疗 Chemotherapy



Since paclitaxel and platinum was discovered, chemotherapy has still been staying one of the first choices for many cancers. Chemotherapy can quickly control certain cancers, but the side effects are too great, causing great pain to patients and reducing the immune system's ability to fight cancer. 80% of patients still develop resistance or relapse.


二.传统外科手术 Traditional Surgery



Advanced spreading cancer cells cannot be completely removed by traditional surgery, and there is a risk of rapid development and distant spread. Therefore, more surgery is often performed in conjunction with chemotherapy, so-called cytoreductive surgery, to remove some or most parts of the tumor that is visible.


三.达芬奇机器人Da Vinci Si(da Vinci robot system)

达芬奇机器人使用微创的方法实施复杂的手术,属于高级的腹腔镜系统。腹腔镜仅二维视觉,而达芬奇机器人的三维视觉可放大10-15倍,使手术精确度大大增加,甚至作为胃癌根治和结直肠癌根治的手段。达芬奇机器人由三部分组成:外科医生控制台、床旁机械臂系统(Patient Cart)和成像系统(Video Cart)。


Da Vinci robots perform complex surgery in a minimal invasive way, an advanced laparoscopic system. Laparoscopy only has two-dimensional vision, while the three-dimensional vision of the Da Vinci robot can be magnified 10-15 times, greatly increasing the precision of surgery, even as a means of radical cure of gastric cancer and colorectal cancer. The Da Vinci robot consists of three parts: Surgeon's Console, Patient Cart and Video Cart.


四.传统放疗 Traditional radiotherapy



Traditional radiotherapy is Photon therapy such as X-ray or γ-ray, used to kill tumor cells. However, it is also harming normal cells, so it cannot completely kill cancer cells.



V. Modern radiotherapies



In recent years, many advanced radiotherapy equipment have been developed, which can powerfully kill cancer cells, with little or no harm to normal cells.


1. 三维适形放射治疗3DCRT

1. 3-dimensional conformal radiation therapy (3D-CRT


2. 调强适形放射治疗

2.Intensity Modulation Conformal Radiation Therapy (IMRT)


It is Intensity-modulated three-dimensional Conformal Radiation Therapy.


3. 伽马刀 Gamma knife



 Stereotactic Radiosurgery (SRS), mainly used for intracranial lesions <3cm.


4. 射波刀Cyber knife



The Cyber knife is an image-guided radiotherapy (IGRT). The robot arm is used to irradiate the target area at the maximum dose, and the surrounding normal tissue is hardly exposed to the radiation, for the treatment of head and whole-body tumors, including lung cancer, brain tumors, Spinal tumors, prostate cancer, pancreatic cancer, liver cancer, kidney cancer and other tumors can kill tumor tissue with only 3 to 5 irradiations.

5. 托姆刀Tomo knife



High-speed spiral radiotherapy system (TomoTherapy) is an image-guided radiotherapy (IGRT) system, which can specisely distinguish the range that needs radiotherapy. It can be used for treatment of whole- body solid tumors, especially tumors near important organs such as brain cancer , Nasopharyngeal cancer, etc., and cancers metastasized.


6. 质子刀 Proton knife


Proton heavy ion radiotherapy is particle radiotherapy. The proton line only releases the maximum energy when it reaches the tumor site, and almost no energy is emitted after passing through the tumor. Therefore, it is possible to precisely keep the radiation energy on the tumor and rarely irradiate the surrounding normal tissue. For all the solid tumors without distant metastases including lung cancer, ovarian cancer, lymphoma, recurrent rectum, ENT tumor, prostate cancer, brain tumor, pancreatic cancer and liver cancer, etc. proston therapy can be considered to be used.


7. 速锋刀 EDGE 




EDGE is a tumor radiosurgery system. it is the most advanced radiotherapy equipment at present, and its high-intensity and precise radiation can remove tumor tissues, with no effect on the surrounding normal tissues and immune system. It can also track and locate "escaped" tumor cells in real time and clear them all. The treatment time is short, 8 to 20 minutes per day for a total of 1 to 5 days. The cost is also very low. The cost of treatment in the United States is about 400,000 yuan RMB, while the cost of treatment in Italy is only about 100,000 yuan RMB. Humanitas Hospital in Milano, Italy is a specialized comprehensive research hospital, research center and teaching center.



VI. (Japan) Boron neutron capturing therapy (BNCT)



BNCT can selectively destroy cancer cells without causing serious damage to normal cells as an effective therapy for highly malignant tumors, including lung cancer, locally recurrent breast cancer, primary brain tumors, melanoma, head and neck tumors, liver tumors, bladder cancer, colon cancer, mesothelioma, etc.




XII. Tumor Treating FieldsTTF)



The TTF device is a special hat or vest that can be carried with all the time. After being powered on, a special electric field can be generated locally. The alternating electric field with a specific frequency and intensity is used to selectively destroy cancer cells and activate the patient's anti-tumor immune response. With continuous treatment, targeting and stop cancer cells, it is especially suitable for brain tumors and solid tumors, without any side effects on normal cells. Experiments have shown that it has better treatment effect than chemotherapy for many cancers such as ovarian, pancreatic, liver, and breast cancers, as well as non-small cell lung cancer, non-small cell lung cancer brain metastasis, malignant mesothelioma, and malignant glioma.




At present, electric field treatment is mainly used in Japan and the United States, but the cost in Japan is much lower than that in the United States, and the device can be brought back to the your own country for long-term and repeated use. Experiments have shown that TTF is more suitable for Asian patients.


XIII. Chemotherapeutic Hyperthermic Intraperitoneal Perfusion (CHIP)



Developed by Polish doctors, CHIP treats advanced cancers including peritoneal cancer, ovarian cancer, bladder cancer, gastric cancer, colorectal cancer, etc., especially effectively reduces cancer recurrence and metastasis in the abdominal cavity. CHIP combined with hyperthermia is used for the treatment of malignant ascites.


治疗方法可以是:经腹腔穿刺放出腹水后,将43-45℃的温度的生理盐水(NS,500 ml)+顺铂(60 mg / m ^ 2)和1000 毫升 NS + 5-FU 500 mg / m ^ 2,在一个小时内迅速注入腹腔,然后通过外部高频热疗仪HG-2000对患者进行高温治疗(60分钟,每周两次),持续两周。


The therapy may be in such a way: normal saline (NS, 500 ml)+Cisplatin (60 mg/m^2) and 1000 ml NS+5-FU 500 mg/m^2  at 43-45℃ is infused rapidly into abdominal cavity in an hour after ascites were drained by perituneucentesis, and then the patient is treated with hyperthermia by external high frequency thermo-therapeutic apparatus HG-2000 (60 min, twice a week) for two weeks.

九.日本)病毒疗法 Viral therapy (Japan)




By modifying infectious viruses, adenoviruses are used to defeat cancer cells.

The key to viral therapy is to ensure that the virus precisely hits cancer cells without harming normal cells, in the way of installing a gene switch for it in order to switch on automatically when it encounters cancer cells. Viral therapy is used to treat pancreatic cancer, malignant melanoma and myeloma , Head and neck cancer, etc.




In addition, oncolytic virus therapy, H101, trade name Oncorine, is a genetically modified virus that preferentially attacks tumor cells and has been used to treat myeloma and head and neck cancers.


十.内分泌疗法 Endocrine therapy



Additive or subtractive endocrine therapy is a conservative (palliative) therapy by reducing hormones to reduce the severity, used for breast cancer, endometrial cancer, ovarian cancer, prostate cancer, etc. And even fome types of breast cancer, ovarian cancer and prostate cancer can be cured by hormonal treatment.


十一.介入疗法 Interventional therapy



Tumor vascular interventional therapy is divided into intravascular intervention and extravascular intervention. Argon-helium knife cryotherapy is extravascular intervention; intravascular intervention means inserting a catheter into the blood vessel that controls the tumor, injecting chemotherapy drugs, or blocking (embolizing) the blood vessel, and "starving" the tumor. Vascular interventional therapy is used for almost all solid cancers, including lung cancer, uterine cancer, and especially liver cancer.


十二.联合疗法 Combined therapy




Combined therapy is very important in cancer treatment.

The combined therapy can be a combination of chemotherapeutic drugs, that is, combined chemotherapy, especially for advanced cancers that are not suitable for radiotherapy and chemotherapy, such as unresectable small cell lung cancer, esophageal cancer, and bladder cancer.





Combined therapies can also be two drugs that are not effective, and the combination can make them better, especially in the treatment of ovarian cancer.

Combined therapy can also be combined use of targeted drugs, which can effectively treat ovarian cancer, brain cancer, lung cancer, neuroblastoma, colon cancer, breast cancer, recurrent head and neck cancer, prostate cancer, melanoma, etc.



There are more combined therapies with immunotherapy, including other types of immunotherapies, chemotherapy, radiotherapy, targeted therapy, vaccines, etc. For example, in radiotherapy + immune combined therapy, radiotherapy can change "cold" tumors into "hot" tumors, which can greatly enhance the effect of immunotherapy.


十三.姑息疗法 Palliative therapy


姑息疗法与临终关怀(hospice care)或临终治疗(end-of-life treatment)不同,不要混淆。


The core of palliative therapy is to improve the quality of patients’lives, reduce their pain, and provide spiritual support and comfort during the cancer treatment.

Palliative therapy is different from palliative care or end-of-life treatment, so don't confuse them.


十四.免疫疗法 Immunotherapy




The target of immunotherapy is not tumor cells and tissues, but the body's own immune system. This is a rapidly developing research direction for tumor treatment. Tumor cells have tumor antigens that can be recognized by the immune system, and this is the basis of cancer immunity. Immunotherapy that causes or enhances the immune response is called activation immunotherapies, and reduction or suppression of the immune response is suppression immunotherapies.

Immunotherapy includes vaccines, checkpoint inhibitor immunotherapy as Anti-PD-1 mAb and anti-PD-L1 mAb, and cellular immunotherapy. Immune effector cells include lymphocytes, macrophages, dendritic cells, natural killer cells (NK cells), and cytotoxic T lymphocytes (CTL).




Chimeric Antigen Receptor T-Cell Therapy (CAR-T) collects immune-aggressive T cells from patients and genetically modifies them so that they can recognize specific targets (antigens) on the surface of the tumor and then transfuse them back into the same patient for cancer cell killing. It is used to treat non-Hodgkin's lymphoma, acute lymphocytic leukemia, glioblastoma, liver cancer, gastric cancer, esophageal cancer, etc.


NK细胞全名自然杀伤细胞(Natural Killer cell,NK)。所有的肿瘤细胞都会首先受到NK细胞的攻击因此具有广谱的抗肿瘤作用,包括肺癌、胰腺癌、肝癌、乳腺癌、胃癌、结直肠癌等。NK细胞治疗配合放化疗,可以有效清除手术不能完全切除的肿瘤细胞。对于不适合做手术或者放化疗的晚期癌症,NK细胞治疗是较好的选择。手术后定期NK细胞治疗可以预防癌症的复发和转移。


NK 细胞 

The full name of NK cell is Natural Killer cells (NK). All tumor cells will be attacked by NK cells first and therefore have a broad spectrum of anti-tumor effects, including lung cancer, pancreatic cancer, liver cancer, breast cancer, gastric cancer, colorectal cancer, etc. NK cell therapy combined with chemoradiation can effectively remove tumor cells that cannot be completely removed by surgery. For advanced cancers that are not suitable for surgery or chemoradiation, NK cell therapy is a better choice. Regular NK cell therapies after surgery can prevent the recurrence and metastasis of cancers


疫苗是免疫疗法的研究热点 ,不仅可以预防癌症例如宫颈癌,也可以激活人体免疫系统杀伤肿瘤细胞。  



Vaccines are a research hotspot in immunotherapy, which can not only prevent cancers such as cervical cancer from developing, but also activate the human immune system to kill tumor cells.

The Cuban vaccine for the treatment of lung cancer, cimavax-EGF, is a biotechnology-based vaccine that targets epidermal growth factor (EGF). The principle of treating cancer is to block the nutrition of cancer cells and starve them. Genetic testing is also available for patients without mutations!


十五.靶向疗法 Targeted therapy



This is a cancer therapy of great significance. In recent years, the study and development of a new generation of anti-tumor drugs has led to the entry of cancer drug therapy into a new era of precise targeted therapy based on genome sequencing test (ie, genetic test). A large number of clinical cases have proven that molecular targeted therapy not only accurately "kills" cancer cells, but also effectively prevents the development of tumors, so as to achieve the so-called "survival with tumor", making cancer a "chronic disease" similar to hypertension and diabetes.



Some cancers can be directly targeted to treatments, such as leukemia, because most of such patients have mutations in the BCR-ABL gene, and the famous "medicine" Gleevec can directly save their lives.




However, more cancers treatment need badly genetical test because different targeted drugs target different target points, so genetic test aiming at determining if a suitable target point exists. In order to promote the effect or prevent drug resistance, it is also possible to use a combination of targeted drugs, use targeted drugs with chemotherapy drugs.




At present, targeted drugs approved by the US Food and Drug Administration (FDA) are mainly used for: gastric cancer, bladder cancer, brain cancer, breast cancer, cervical cancer, colorectal cancer, cutaneous sarcoma, head and neck cancer, neuroendocrine tumor, gastrointestinal stromal tumor, giant cell tumor of bone, kidney cancer, leukemia, liver cancer, lung cancer, lymphoma, multiple myeloma, neuroblastoma, epithelial ovarian cancer, primary peritoneal cancer, pancreatic cancer, prostate cancer , soft tissue sarcoma, thyroid cancer, and solid tumors with NTRK or microsatellite defects.



未完待续 To be continued



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