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Cancer is Curable, Organ and Function Preservation is Possible!!

By Dr. Sajal Kakkar in Cancer Care / Oncology

Jan 31 , 2022 | 3 min read

Whether cancer is curable – This Question has been asked a number of times. The answer is - YES! More than two-thirds of the cancers are curable, if treated early and adequately. For People who have been treated successfully for cancer and it doesn’t recur for the next five years, the chances of it recurring are very rare.

There are three determinants for cancer cure – the type of cancer, stage at diagnosis, and adequacy of the treatment. If the disease is diagnosed early, there are higher chances of survival. Today two-third of people live for at least five years after a cancer diagnosis due to improvement in understanding of cancer biology, advances in prevention and treatment of the cancer. But still, there are challenges remaining, such as early detection of cancer, making treatment accessible to everyone, to search for new avenues to treat resistant cancers.

Curing cancer at any cost is not accepted casually in recent times. More than ever before, a premium is being placed on return to a productive and useful lifestyle after cancer treatment. The concept of Organ Preservation has been at the forefront of modern cancer care for the past two decades. The preservation of organ form and function is now the standard of care in numerous malignancies, including breast, larynx, rectum, anal canal, bladder, sarcomas of the limb. To be generally adopted, organ conservation approaches must have a likelihood of eradicating the tumor, have a low risk of recurrence, and not compromise on organ form and function.

Let’s consider a few examples where organ preservation strategies have really made a difference in the patient’s quality of life:

Throat Cancers (Larynx, Pharynx) – Traditionally, the treatment of throat cancers involved total laryngectomy (removal of the voice box) and radiotherapy either used alone or in combination. This radical surgery amounts to the loss of speech, compromise in respiration and swallowing functions.  The significant technological advancements in radiation delivery, availability of effective chemotherapy drugs, voice rehabilitation have shifted the focus to ‘Organ Preservation.  The co-administration of chemotherapy and radiotherapy in properly selected patients has provided reasonable tumor control rates, organ preservation, and maintenance of the quality of life of the patients.

Breast Cancer – Mastectomy i.e., complete removal of the breast and adjacent tissues has been the traditional standard surgery for patients diagnosed with breast cancer. This procedure not only leads to restriction of movements of the arm, but has a profound impact on the patient’s psyche. The loss of breast has a significant bearing on the quality of life of breast cancer patients.  With a better understanding of tumor behaviour and technological advancements, mastectomy has been replaced by Breast Conservation surgery, where only the tumor-bearing area and a rim of adjacent normal tissue are is removed with acceptable cosmesis. This technique has shown equivalent tumor control rates and is now a widely accepted modality in the treatment of breast cancer.

Bladder Cancer – Cystectomy i.e. removal of the urinary bladder with an artificial passage of urine through the abdominal wall is the standard of care with muscle-invading bladder cancers. The advancements in radiation planning and delivery techniques, availability of effective and less toxic chemotherapy drugs, have led to the development of bladder preserving approaches in carefully selected patients.

Rectal Cancer – Strong considerations are given to the functional outcomes while deciding the treatment protocol for rectal cancers. The restoration of bowel function, anal continence are the issues on which premium is placed. In recent times, the use of pre-operative chemo-radiation protocols have led to the downstaging of the tumor, improved resectability, and preservation of anal sphincter, which has a significant impact on patients quality of life.

Anal Cancer – The traditional approach in the management of anal cancers involved loss of anal sphincter, permanent bag on the abdominal wall for passage of stools. In the last three decades, chemo-radiation has become the standard of care with preservation of anal sphincter and obviating the need for permanent stoma.

Soft Tissue/ Bone Sarcoma of Limbs – The traditional approach of amputation in these cancers dealt a significant blow to the patient’s quality of life. With the advancement and refinement of surgical techniques, rehabilitation services, and effective chemotherapy drugs, limb preservation protocols are commonly practiced.

Multi-disciplinary collaborative approaches with knowledge and respect for the benefits and shortcomings of individual treatment modalities have led to the development of organ preservation protocols. Further efforts are being made in the endeavour to improve the quality of life of cancer patients and provide acceptable cure rates.