Cancer risk counseling can provide peace of mind for you and your family members. With a comprehensive cancer risk assessment and genetic counseling, the reality of your risks can be determined. If it is found that a genetic change has increased your risk of cancer, you can then use this knowledge to take measures that may reduce your risk.

Reducing Risks

Knowing you are at risk is invaluable in helping you and your healthcare provider manage your care. In most cases, there are three options for reducing cancer risks: increased surveillance, preventive medications and/or preventive surgery.

Genetics and Cancer

After looking at your family history, it may be possible to take advantage of today’s technology of gene identification to give you and your family a better understanding of your cancer risks.

Cancer is thought to be the result of many factors, such as genetics, environmental exposure and lifestyle. Although the majority of cancers are not inherited, recent research has found that inheritance can greatly increase the likelihood of some cancers. Researchers have discovered that there is more cancer in certain families due to an abnormal gene that is passed from generation to generation.

The goal of genetic testing at the Ochsner Cancer Center of Acadiana - Crowley is to develop a personal risk plan to prevent cancer development or allow for early detection of the disease.

Are you at risk?

If you answer “yes” to any of the following questions, talk to your physician or health care professional about a hereditary risk assessment.

• Do you or a family member have a history of cancer at an early age (before age 50)?

• Do you have several family members with the same type of cancer?

• Do you or a relative have more than one type of cancer diagnosis?

• Do you have a rare cancer that has occurred in your family, such as male breast cancer?

• Do you or anyone in your family have a diagnosis of ovarian cancer?

• Do you have Eastern European Jewish ancestors?

Choice of cancer treatment is influenced by several factors, including the specific characteristics of your cancer; your overall condition; and whether the goal of treatment is to cure your cancer, keep your cancer from spreading, or to relieve the symptoms caused by cancer. Depending on these factors, you may receive one or more of the following. An important part of treatment is to spot and report your side effects early.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to destroy cancer cells. It is also called “chemo.” Today, there are many kinds of chemotherapy. So, the way you feel during treatment may be very different from someone else.

How can chemotherapy help me?

Chemotherapy can be used to:

• Destroy cancer cells
• Stop cancer cells from spreading
• Slow the growth of cancer cells
  Chemotherapy can be given alone or with other treatments. It can help other treatments work better. For example, you may get chemotherapy before or after surgery or radiation therapy. Or you may get chemotherapy before a peripheral blood stem cell transplant. Check with your doctor or nurse before you take any medicine, vitamins, or herbs. Some of these can change the way chemotherapy works.

How is chemotherapy given?

Chemotherapy can be given in these forms:

• An IV (intravenously)
• A shot (injection) into a muscle or other part of your body
• A pill or a liquid that you swallow
• A cream that is rubbed on your skin
• Other ways

When will I get chemotherapy?

You may get treatment every day, every week, or every month. The treatment period is followed by a period of rest when you won’t get chemotherapy. This rest period gives your body a chance to build healthy new cells.

Your doctor or nurse will talk with you about your treatment schedule. Ask for a written copy of it, as well.

How will I feel during treatment?

Each person and treatment is different, so it is not always possible to tell how you will feel. Some people feel well enough to keep their normal schedules at home or at work. Others feel more tired. Today, many side effects can be prevented or controlled. Talk with your doctor or nurse to learn what side effects you may have and how to manage them.

Radiation Therapy via the CyberKnife System

Radiosurgery and radiotherapy are delivered via the CyberKnife^® system, at Ochsner Lafayette General’s CyberKnife Center – Louisiana

The CyberKnife system is exceptionally accurate because of two key advancements:

1. A robotic arm which can point the radiation treatment at the patient’s tumor from a wide variety of angles. In fact, the CyberKnife can irradiate the tumor from over 1200 angles. The tumor is hit from multiple angles many times, so that the cumulative radiation dose is much more intense than standard radiation therapy.
2. Multiple X-ray and stereoscopic video cameras, which when combined with powerful tracking software, can localize the tumor’s position. The cameras obtain frequent pictures of the patient during treatment and use this information to target the radiation beam emitted by the linear accelerator. This enables CyberKnife to precisely treat tumors that move with respiration, such as lung cancers.

Radiation therapy, also called radiotherapy or irradiation, is the use of a certain type of energy (called ionizing radiation) to kill cancer cells and shrink tumors. Radiation therapy selectively injures or destroys tumor cells in the area being treated by damaging their genetic material and making it impossible for these cells to continue to grow and divide. Although radiation damages both cancer cells and normal cells, most normal cells can recover from the effects of radiation and function properly.

In some cases, the goal of radiation treatment is the complete destruction of an entire tumor. In other cases, the aim is to shrink a tumor and relieve symptoms. In either case, doctors plan treatment to spare as much healthy tissue as possible.

There are different types of radiation and different ways to deliver the radiation.

What is the difference between external radiation therapy, internal radiation therapy (brachytherapy), and systemic radiation therapy? When are these types used?

Radiation may come from a machine outside the body (external radiation), may be placed inside the body (internal radiation), or may use unsealed radioactive materials that go throughout the body (systemic radiation therapy). The type of radiation to be given depends on the type of cancer, its location, how far into the body the radiation will need to go, the patient’s general health and medical history, whether the patient will have other types of cancer treatment, and other factors.

What are stereotactic radiosurgery and stereotactic radiotherapy?

Stereotactic (or stereotaxic) radiosurgery uses a single large dose of radiation to destroy tumors in the brain or the body. The procedure does not involve actual surgery. The dose and area receiving the radiation are delivered with extremely high precision. Most nearby tissues are not damaged by this procedure.

Stereotactic radiotherapy uses essentially the same approach as stereotactic radiosurgery to deliver radiation to the target tissue. However, stereotactic radiotherapy uses multiple radiation treatments, between two to five daily treatments. Giving multiple smaller doses may improve outcomes and minimize side effects.

Stereotactic radiotherapy is used to treat tumors in the brain as well as other parts of the body.

Surgery

In most cases, the surgeon removes the tumor and some tissue around it. Removing nearby tissue may help prevent the tumor from growing back. The surgeon may also remove some nearby lymph nodes.

The side effects of surgery depend mainly on the size and location of the tumor, and the type of operation. It takes time to heal after surgery. The time needed to recover is different for each type of surgery. It is also different for each person. It is common to feel tired or weak for a while.

Some people worry that having surgery (or even a biopsy) for cancer will spread the disease. This seldom happens. Surgeons use special methods and take many steps to prevent cancer cells from spreading. For example, if they must remove tissue from more than one area, they use different tools for each one. This approach helps reduce the chance that cancer cells will spread to healthy tissue.

There are many specialists at our center who work with our medical oncologists if surgery is indicated, including general surgeons, urologists and a specialty-trained surgical oncologist. Our gynecologic oncologist specializes in advanced pelvic surgery.

Hormonal Therapy

Some cancers need hormones to grow. Hormone therapy keeps cancer cells from getting or using the hormones they need. It is systemic therapy. Hormone therapy uses drugs or surgery:

• Drugs: The doctor gives medicine that stops the production of certain hormones or prevents the hormones from working.
• Surgery: The surgeon removes organs (such as the ovaries or testicles) that make hormones.
  The side effects of hormone therapy depend on the type of therapy. They include weight gain, hot flashes, nausea and changes in fertility. In women, hormone therapy may make menstrual periods stop or become irregular and may cause vaginal dryness. In men, hormone therapy may cause impotence, loss of sexual desire and breast growth or tenderness.

Biological Therapy

Biological therapy is a type of treatment that works with your immune system. It can help fight cancer or help control side effects (how your body reacts to the drugs you are taking) from other cancer treatments like chemotherapy.

What is the difference between biological therapy and chemotherapy?

Biological therapy and chemotherapy are both treatments that fight cancer. While they may seem alike, they work in different ways. Biological therapy helps your immune system fight cancer. Chemotherapy attacks the cancer cells directly.

How does biological therapy fight cancer?

Doctors are not sure how biological therapy helps your immune system fight cancer. But they think it may: Stop or slow the growth of cancer cells; make it easier for your immune system to destroy, or get rid of, cancer cells; keep cancer from spreading to other parts of your body.

What are the names of some biological therapy?

There are many kinds of biological therapy. Here are the names of some common ones with ways to say them and brief statements about how they are used in cancer care.

Treatments for cancer:

• BCG or Bacillus Calmette-Guérin (ba-SIL-us KAL-met gay-RAIN) treats bladder tumors or bladder cancer.
• IL-2 or Interleukin-2 treats certain types of cancer.
• Interferon alpha treats certain types of cancer.
• Rituxan or Rituximab treats non-Hodgkin’s lymphoma.
• Herceptin or Trastuzumab treats breast cancers

Treatments for controlling side effects:

• Neupogen or G-CSF increases white blood cell counts and helps prevent infection in people who are getting chemotherapy.
• Procrit, Epogen, or Erythropoietin helps make red blood cells in people who have anemia.
• IL-11, Interleukin-11, Oprelvekin, or Neumega, helps make platelets (a type of blood cell).

What are cancer vaccines?

Cancer vaccines are a form of biological therapy. While other vaccines (like ones for measles or mumps) are given before you get sick, cancer vaccines are given after you have cancer. Cancer vaccines may help your body fight the cancer and keep it from coming back.

Doctors are learning more all the time about cancer vaccines. They are now doing research about how cancer vaccines can help people diagnosed with melanoma, lymphoma, and kidney, breast, ovarian, prostate, colon and rectal cancers.