The word "cancer" can make us all feel a great sense of fear. But with the advancement of medical science, there are now very powerful treatments to fight this disease. You may have heard of chemotherapy, which is the administration of drugs that directly destroy cancer cells. Also, a new treatment that is currently being talked about a lot is immunotherapy. This involves stimulating our own body's immune system and making it fight cancer. But sometimes it can be difficult to achieve the desired results with just one treatment. That is why the concept of "Combination Care" that we are talking about today comes to the fore.
Why combine these treatments?
Simply put, a team of warriors with diverse abilities is more likely to win than a single warrior fighting alone. The same is true in cancer treatment. When one or more treatments are used together, the chances of controlling the cancer, completely curing it, or extending the patient’s life are increased.
These combination therapies are particularly important for severe or advanced cancers, such as lung cancer and skin melanoma.
What are the main expectations from combining these treatments?
- Strengthening our immune system's fight against cancer: Some treatments help the immune system recognize cancer cells more easily.
- Disrupting the ability of cancer cells to "hide" from the immune system: Cancer cells are very cunning cells. They use various strategies to evade our immune system. Combination therapies can disrupt these strategies.
- Reducing the number of cancer cells or the size of a tumor: When one treatment shrinks a tumor, it becomes easier for another treatment to destroy the remaining cells.
Commonly used combination therapies
Doctors combine different treatments. Let's look at a few of them.
1. A special class of immunotherapy called Checkpoint Inhibitors
This is a very interesting treatment. Think of our immune system as an army that defends the country. These army cells (T-cells) can identify and attack enemy cells. But sometimes cancer cells turn off the "checkpoints" in these army cells and play a trick, saying, "I'm one of yours, don't attack me."
What drugs called `Checkpoint Inhibitors` do is turn the switch that cancer cells have turned off back on. Then our immune system can recognize cancer cells and start attacking them.
More than 75% of immunotherapy research today combines these checkpoint inhibitors with other treatments. This approach helps shrink many types of cancer, providing long-term results with fewer side effects.
For example, the combination of two checkpoint inhibitor drugs, ipilimumab and nivolumab, has been used successfully for many years to treat aggressive melanoma that has spread to the brain.
This compound is now approved for kidney, colon, liver, lung, and several other types of cancer.
2. Combining Immunotherapy and Chemotherapy
This is also a method that has shown very successful results. While chemotherapy destroys cancer cells, immunotherapy helps the immune system find and destroy the remaining cells.
| Cancer type | The advantage of combination therapy |
|---|---|
| Breast Cancer | Some types of breast cancer are difficult for the immune system to recognize, but combining immunotherapy with chemotherapy (e.g., Taxol) has shown very good results. |
| Pancreatic Cancer | Combining chemotherapy with immunotherapy drugs such as nivolumab has yielded good results for pancreatic cancer that has spread throughout the body. |
| Blood Cancers | Treatments such as CAR T-cell therapy are very successful for blood cancers such as leukemia. In addition, combining checkpoint inhibitor drugs with chemotherapy has almost doubled the success rate of patients who did not respond to treatment. |
| Cervical Cancer | For cancers that recur after chemotherapy and radiation, the addition of immunotherapy has significantly increased patients' survival. |
3. Combining Immunotherapy and Targeted Therapy
`Targeted Therapy` is a different approach than chemotherapy. Chemotherapy can affect all rapidly dividing cells (cancer cells as well as healthy cells). However, `Targeted Therapy` targets and attacks a specific genetic or protein defect that causes cancer cells to grow.
Combining this approach with immunotherapy is now also showing promising results. For example, these combination therapies are now approved for kidney cancer and endometrial cancer.
4. Surgery with Immunotherapy
This is also a very important approach.
- Before surgery: Immunotherapy can shrink the size of the cancer, making surgery easier and reducing the amount of tissue to be removed.
- After surgery: Immunotherapy can help the immune system destroy very small cancer cells (micrometastases) that may remain invisible to the naked eye after surgery. This reduces the risk of the cancer coming back.
This method has shown very good results for brain, lung, breast, colon, and oral cancers.
5. Immunotherapy with Radiation Therapy
Radiation therapy shrinks tumors. Researchers also believe that the signals emitted by irradiated cancer cells make it easier for the immune system to recognize the cancer. Therefore, research is still ongoing to see if combining immunotherapy with radiation therapy can further enhance the effectiveness of the treatment.
Most importantly: If you or someone close to you has cancer, it is essential to have an open and thorough discussion with your doctor about what treatment is best for you, whether combination therapy is needed, and what the pros and cons are. Information on the Internet is for informational purposes only and should never be considered a substitute for medical advice.
Take-Home Message
- Combination care often provides more successful results than a single treatment for cancer.
- Treatment plans are designed by combining methods such as immunotherapy, chemotherapy, targeted therapy, surgery, and radiation therapy in various ways.
- These combination therapies can achieve goals such as destroying cancer cells, strengthening the immune system, and preventing cancer recurrence.
- This is a rapidly developing field, with new and more effective treatment combinations being introduced constantly.
- Only your oncologist can determine the best treatment plan for you, so discuss all decisions with your doctor.
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