Asbestos Cancer Update 2008

This answer varies, depending on the type and extent of cancer being treated. Many patients will have radiology studies (CT scans, MRIs, PET scans) periodically to see if the tumor has responded (either shrunk or stayed the same versus grown). Some types of tumors can be measured in the blood with a “tumor marker“. This is a substance that is either produced by the tumor or by the body in response to the tumor, and can be measured by a blood test. If the chemotherapy is working, one would expect the tumor marker to decrease. In some cases, a decrease in a patient’s symptoms may signal whether or not the medications are shrinking the tumor. Talk with your doctor or nurse about how your response will be measured.

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Although these therapies use substances that occur naturally in the body, side effects can occur as a result of either the greater production or the higher-than-normal doses administered. The most common side effects with biologic therapies are caused by the “revving up” and stimulation of the immune system. They include fever, chills, body aches, nausea/vomiting, loss of appetite, and fatigue. Depending on the doses and how the therapy is administered, patients may experience a decrease in their blood pressure and may develop a rash or swelling at the injection site. Most side effects diminish at 24-48 hours after treatment, and for continuous regimens these side effects will lessen over time. Remember, every patient is different; some may develop all of the side effects, while others may have none or be somewhere in between. Biologic therapies are relatively new, and not much is known about what long-term side effects (years later) they may lead to. Visit OncoLink Rx to learn more about a specific therapy.

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This varies depending on the particular type of biologic therapy being used. Therapies may be given by mouth, into a vein (intravenously) or by injection, either under the skin (subcutaneous) or into a muscle (intramuscular). Therapies may also be given directly into a body cavity to treat a specific site. For example, gene therapy directed against mesothelioma (a type of lung cancer) may be injected directly into the lung. Some of these therapies are approved by the U.S. Food and Drug Administration, but many are still being tested in clinical trials. Depending on the type of cancer and how far it has spread, some patients may only need biologic therapy, while others may receive this in conjunction with other therapies ( chemotherapy, surgery, or radiation therapy).

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Biologic therapies help the immune system to function better by using substances that occur naturally in your body. The therapy may stimulate your body to make more of the substance, or the therapy may be a man-made version of that natural substance itself. Other types of therapies use cells from the patient’s body, which are then altered in a laboratory and given back to the patient. Alternative names for biologic therapies include biologic agents, biologicals, biological response modifiers (BRMs), or immunotherapy.

The body’s immune system helps to prevent disease, but it also plays a role in preventing cancer from developing or spreading. The goal of biologic therapy is to enhance this natural defense and its ability to fight cancer. Doctors do not completely understand how these therapies work to fight cancer, but the treatments are thought to stop or slow the growth of cancer cells, to make it easier for the immune system to destroy these cells, and to prevent cancer from spreading to other parts of the body.

Some biologics are used to help deal with the side effects of other treatments. For example, colony stimulating factors can help the body increase the production of white blood cells after chemotherapy and thereby decrease the risk of neutropenia and, in turn, infection. Just as there are many different ways of stimulating the immune system, there are different types of biologic therapies. Some of the biologic therapies include: interferon, interleukin, colony stimulating factors, monoclonal antibodies, vaccines and gene therapy.

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Department of Radiation Oncology, University Hospital of Heidelberg, Heidelberg, Germany.

BACKGROUND:: The current study was conducted to evaluate the outcome of carbon ion radiotherapy (RT) in children and young adults with skull base chordomas and chondrosarcomas. METHODS:: Between 1997 and 2007, 394 patients were treated with carbon ion RT at Gesellschaft für Schwerionenforschung in Darmstadt, Germany. Of these patients, 17 patients were aged </=21 years. Seventeen of these young patients were treated for chordoma or low-grade chondrosarcoma of the skull base and were analyzed in this study. Irradiation was performed after primary diagnosis in 14 patients (82%) and for recurrent tumors in 3 patients (18%). The authors applied a median total dose of 60 gray equivalents (Gy E) (range, 60-66.6 Gy E) in a fractionation of 7 x 3 Gy E per week of carbon ion RT using the raster scan technique. All patients were observed prospectively on a regular basis after carbon ion RT. RESULTS:: The median follow-up time was 49 months. Treatment was well tolerated without severe side effects and could be completed on an outpatient basis in all patients without interruptions. One patient with chordoma developed tumor progression at 60 months after carbon ion RT. All other patients demonstrated no signs of tumor progression during follow-up. CONCLUSIONS:: Despite its promising outcome in children and young adults with chordomas and chondrosarcomas, further evaluation in a larger patient collective is required. Randomized studies comparing the outcome after carbon ion RT with proton RT are especially needed to evaluate the role of particle beams in the treatment of skull base tumors in children and young adults. Cancer 2009. (c) 2009 American Cancer Society.

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