tailieunhanh - Basic Oncology including Treatment in Less-resourced Locations

This chapter in cell death. will focus on non-surgical approaches namely radio- therapy, chemotherapy and hormonal therapy. There are limited facilities for radiotherapy as duction of free radicals cal personnel to plan treatment and operate these and break chemical bonds thus causing cell damage radiotherapy facilities in many of the less-resourced costly for many less-resourced locations. | 31 Basic Oncology including Treatment in Less-resourced Locations Suresh Kumarasamy INTRODUCTION The treatment of most types of gynecological cancers is complex and often requires multiple modalities of treatment. While surgery is the cornerstone of the treatment of early cervical cancer ovarian cancer endometrial cancer and uterine sarcoma early vulval and vaginal cancer as well as breast cancer radiotherapy and chemotherapy also play important roles. The surgical approaches have been discussed in Chapters 26 28-30. This chapter will focus on non-surgical approaches namely radiotherapy chemotherapy and hormonal therapy. There are limited facilities for radiotherapy as well as a shortage of trained medical and paramedical personnel to plan treatment and operate these radiotherapy facilities in many of the less-resourced locations. Many of the newer drugs that are used for chemotherapy are either not available or too costly for many less-resourced locations. Fortunately the availability of generic chemotherapeutic agents has made the use of some of these chemotherapeutic agents possible. We are aware that the accessibility for both radiotherapy and chemotherapy is limited however in middle-income countries many services are available. It is good to find out where the nearest referral facility is and whether a national cancer control plan exists. If you work in a referral setting extensive knowledge of adjuvant treatment is necessary. To improve quality of care it is good to write treatment protocols and make sure that every healthcare worker involved is adequately trained and capable. In this chapter the general aspects of radiotherapy and chemotherapy will first be described followed by specific details for the treatment of gynecological malignancies and breast cancer. An overview on hormonal systemic therapy in breast cancer is provided in Chapter 30. RADIOTHERAPY Radiotherapy exerts its therapeutic effects in the cell by both direct and indirect actions. The .

• Basic Oncology including Treatment
• Less resourced Locations
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• Hormonal therapy
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