Cancer Treatment (Oncology)

The center of cancer treatment: Medical oncology

Medical oncology is a branch of science that covers not only the treatment of cancer patients but also cancer protection, cancer screening, and early diagnostic applications.

Moreover, in cancer diagnosis and treatment, there is cooperation between various fields such as surgery and radiology. The approach to patients is planned in a multidisciplinary way in line with scientific data.

In medical oncology, treatment planning changes based on:

• The cell type of cancer
• The organ in which it first appeared
• The areas to which it has spread

Types of treatment used in medical oncology

Chemotherapy (medicated therapy): Chemotherapy aims to destroy cancerous cells that grow in an uncontrolled manner due to some changes in their structures. In Acibadem Oncology Centers, we apply the most recent developments in this field to treat our patients.

Hormone therapy: Hormonal drugs are used in the treatment of tumors that are sensitive to hormones, such as prostate and breast cancers.

Immunotherapy (treatment via the immune system): Substances that the immune system naturally produces are used to identify and kill cancerous cells by alerting the body’s immune system to the presence of the cells.

Target-driven biological therapy: One of the most important developments of the last decade in cancer treatment has been highly effective biological therapies. This treatment type has relatively few side effects and identifies targets that are present in cancerous cells but not in normal cells.

Targeting cancer cells: Radiation oncology

Radiation oncology uses ionizing radiation to examine the effects of radiation on cancer and the behavior of tumors and also covers research in this field. Radiation oncology has two areas of application: Radiotherapy and radiosurgery.

Radiotherapy (x-ray therapy)

Radiotherapy is defined as the treatment of cancerous tissue or some non-malignant tumors with radiation. It is also colloquially referred to as radiation therapy or x-ray therapy. The beams used in radiotherapy aim to stop cancerous cells from growing or kill them.

Fields of application for radiotherapy

Curative radiotherapy: In light of the available information about the disease, this is applied in cases where the disease can be completely treated. It can be applied alone or with surgery and/or chemotherapy.

Palliative radiotherapy: This is applied in cases where it is impossible to destroy the disease. The goal is to prevent and relieve suffering and improve the quality of life for people facing serious, complex illnesses.

Scalpel-free and bloodless surgical treatment using beams: Radiosurgery

The fundamental aim of radiosurgery, one of the fields of application of radiation oncology, is to direct many low-energy beams to the diseased area to shrink or kill the cancerous cells with the intense beams while protecting the surrounding healthy tissues from the harmful effects of radiation.

Techniques used in the application of radiation oncology

IGRT: Image-guided radiation therapy

IMRT: Intensity-modulated radiation therapy

Conformal Radiotherapy: Three-dimensional conformal radiotherapy

SRT/SRS: Stereotactic radiosurgery refers to the destruction of a tumor in a single session through high doses of radiation. When this therapy is applied over more than one session (generally 3–5 sessions), it is called stereotactic radiotherapy.

Rapidarc: Rapidarc is a highly developed technology that provides greater comfort and ease for the patient by reducing the length of radiotherapy sessions from 15–30 minutes to as little as two minutes.

Brachytherapy: Brachytherapy is a method used to increase local control of the disorder by raising the dose of radiation applied to the tumor before and after external radiotherapy.

Single dose radiation therapy: Single-dose radiotherapy begins, preferably after chemotherapy, in patients who require it or at least three weeks after surgery in patients who are only treated with hormone therapy.

Treatment devices used in the application of radiation oncology:

Trilogy: The Trilogy device allows for accurate intervention by specialists in the shortest amount of time and in the ideal dose. This means that the patient receives the most accurate treatment in the shortest amount of time.

MRIdian®: This is the world’s first radiotherapy device with integrated onboard magnetic resonance imaging (MRI) for image guidance. This device can provide continuous and real-time-based imaging before and during treatment.

Truebeam®: This is a system to treat cancer with speed and accuracy while avoiding damage to healthy tissues and organs. The most important feature of TrueBeam® is that it can provide fast, safe, and effective treatment.

CyberKnife®:This is a robotic radiosurgery system with high precision to within a millimeter. Using this system, cancerous regions in the brain or body can be treated with high doses by using radiation beams focally. In this procedure, healthy tissues can be maximally protected against the side effects of radiation.

Gamma Knife® Icon™: Gamma Knife® is a stereotactic intracranial radiosurgery technique that is used for treating brain tumors and other brain abnormalities as part of radiation therapy. In Gamma Knife® radiosurgery, the targeted tissues receive a very high dose of radiation in a single session. This procedure aims to stop the growth of the tumor.

Application Fields of Surgical Treatment

Curative surgery is also applied within the scope of surgical oncology. However, the preliminary condition for applying curative surgery is that the disorder is limited to the organ or lymph nodes where it first appeared. Tumors may be completely removed from patients provided that their boundaries are well defined. However, there are cases in which the tumor cannot be completely removed. In such cases, debulking surgery may be applied to minimize the bulk. Moreover, the removal of metastases that are low in number improves a patient’s chance of a sound recovery.

Robotic Surgery with “da Vinci”

Laparoscopic operations that are performed with the da Vinci surgical robot are referred to as robotic surgery. These operations provide numerous advantages to the patient. In addition to the common advantages of all laparoscopic operations, such as minimal pain and scarring and a short hospital stay, there is also less bleeding in laparoscopic surgeries than in traditional surgeries, and the success rate is higher. da Vinci robotic surgery is performed in the following major areas: gynecology, gynecologic oncology, urology, cardiac and vascular surgery, general surgery, and ear-nose-throat surgery.

The first step towards accurate treatment: Radiological diagnostic methods

An accurate radiological diagnosis is an essential part of deciding how treatment should be performed. Modern techniques and advanced technologies, as well as experienced radiology staff, are of paramount importance when performing radiological diagnoses.

In addition to qualified radiology staff, techniques applied with advanced technologies must be used to achieve an accurate diagnosis. At Acibadem Healthcare Group, we work according to this principle and closely follow developments in medical science, constantly replacing our diagnostic equipment in all our hospitals and outpatient centers with new, high-tech equipment.

Positron emission tomography/Computed tomography

For rapid and reliable diagnosis: The positron emission tomography/computed tomography (PET/CT) device is used to identify tumors in their early stages, particularly for cancer treatment, and to determine whether these tumors are malign or benign. The device is also used in the diagnosis and treatment of neurological and cardiological disorders.

PET/CT in early diagnosis: PET/CT offers significant advantages in the early diagnosis of many disorders. In pre-PET/CT periods, an early diagnosis was made only by a biopsy to determine whether nodules in the body were cancerous or not, whereas this can now be determined with a high rate of precision using PET/CT.

PET/CT in metastasis: PET/CT also offers a significant advantage for the determination of whether the disease has spread to the adjacent tissues or lymph nodes in many cancer types, i.e., whether there is metastasis. Since the entire body is visualized at the same time via the images taken using PET/CT, it is also possible to evaluate whether cancer has spread to other organs. Thus, PET/CT is highly advantageous in determining, for instance, whether a tumor in the lung has spread to other internal organs, the adrenal glands, or the lymph nodes (i.e. determining whether there is metastasis). In other words, PET/CT can be used to determine the extent of the disorder, which is known as staging.

INTRAOPERATIVE 3 TESLA MRI

Intraoperative MRI facilitates the complete removal of a tumor by providing images during brain surgery. It thus eliminates the risk of a second operation that would be required due to residual tumor.

DIGITAL MAMMOGRAPHY WITH TOMOSYNTHESIS

This is a mammography device that delivers excellent two- and three-dimensional image quality at the lowest possible dose. With its two-dimensional and multi-slice, three-dimensional tomosynthetic imaging capacity, it offers groundbreaking possibilities in the early diagnosis of cancer.