Cancer is the second cause of death for both younger people and older people in the Western world. Although about 50% of patients with diagnosed cancer can be cured with the conventional modalities of cancer treatment, the other half will die of the disease. The chances of survival from cancer strongly cOlTelate with the type of cancer and with the stage of the disease at the time of diagnosis. After a malignant tumor has been diagnosed, the therapy of choice will also depend upon the type of tumor and the tumor stage. Surgery is the most widely used approach in cancer therapy. Surgical excision is both quick and effective and it accounts for the largest number of cures. Unfortunately, this form of treatment has several drawbacks. Removal of the tumor mass visible to the surgeon does not guarantee elimination of all tumor cells. In order to remove all tumor tissue, the surgeon may be forced to cut out healthy tissue and, in doing so, may severely damage the patient's functioning or appearance. Surgery can be combined with radiation therapy to eliminate residual tumor cells or microscopic invasions of malignant cells in slllTounding tissues. Radiation therapy can be preferable to surgety in some instances. Because healthy tissues usually recover from radiation exposure more readily than cancerous cells, radiation therapy can preserve the anatomical structures surrounding the tumor. Still, it should be noted that radiation therapy will cause problems, most of which will disappear when therapy cycles are completed. Radiation therapy is especially important for tumors not accessible for surgety (e.g. some brain tumors) or for treating cancers of the latynx (voice box). In this way cancer of the latynx can be cured without impairing the patient's ability to speak. Chemotherapy is a systemic therapy, required when the tumor cells have all'eady spread throughout the body, or when no solid tumor is present, as is the case in leukemia. A drawback of chemotherapy are the side effects, preliminaty caused by the fact that normal dividing cells are also killed by the chemotherapeutic agent.

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W. van Ewijk (Willem)
Erasmus University Rotterdam
Erasmus MC: University Medical Center Rotterdam

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