Oncology is the study of malignant disease, or cancer. Oncologists study cancer and treat patients with cancer, including cancers of the breast, prostate, colon, lung, ovaries, brain, blood, and many other types. Medical Oncologists like those of Steelhead Oncology use systemic therapies to manage cancer; these therapies include chemotherapy, hormonal therapies, targeted therapies, immunotherapy, and other modalities.

WHAT IS CHEMOTHERAPY?
Chemotherapy means chemical treatment of disease. While this word invokes a certain mental image, it is important to understand not all chemotherapy is the same. There are many different classes of chemotherapy, including cytotoxic therapy, immunotherapy, hormone therapy, targeted therapy, immunomodulatory therapy and others, all of which have different side effect profiles. Use of chemotherapy can be traced back to the ancient Greeks but has been used in modern medicine since the 1940s. Since its reintroduction into modern medicine, our understanding of cancer and our ability to treat it with chemicals has exponentially increased and continues to do so. Fortunately, most new therapies are more sophisticated in their approach to killing cancer, resulting in fewer side effects and less toxicity for the patient. Additionally, our ability to control the side effects of cancer treatment continues to advance and improve the tolerability of treatment for our patients.

HOW DOES CHEMOTHERAPY WORK?
A feature of cancer cells is their ability to grow and divide at a much more rapid rate than normal cells, and in an uncontrolled manner. Chemotherapy disrupts the process of cellular growth and replication, leading to the death of that growing cell. Since cancer cells are growing more rapidly than normal cells, chemotherapy will preferentially target the cancer cells. Different drugs will accomplish this goal through different mechanisms, which is why drugs are often used in combination to maximize the outcome of therapy.

HOW DOES YOUR DOCTOR CHOOSE WHAT CHEMOTHERAPY TO GIVE?
The specific choice of agents in a chemotherapy regimen is based upon many factors, including but not limited to the specific type of cancer, stage of cancer, overall health of the patient, goals of therapy, research and national guidelines. The treatment options offered at Steelhead Oncology have been rigorously tested through the multiphase clinical trial process utilized in medical research. Adherence to national guidelines assures your treatment approach is similar regardless of where you receive your therapy. Every treatment plan will be customized by your physician for your individual case.

CHEMOTHERAPY TERMS
Adjuvant chemotherapy - Chemotherapy given following surgery. The goal is to destroy any microscopic cells that may remain after resecting the visible tumor, and prevent a possible cancer recurrence.

Neoadjuvant chemotherapy - Chemotherapy given prior to surgery to remove the cancer. Neoadjuvant chemotherapy is given to reduce the size of the tumor prior to surgery in order to minimize the extent of surgical resection.

Induction chemotherapy - Chemotherapy given to induce a remission. This is a term typically used in blood cancers.

Consolidation chemotherapy - Chemotherapy given once a person is in remission. The goal of this therapy is to sustain the remission.

Maintenance chemotherapy - Chemotherapy given in lower doses to assist in maintaining a response. The lower dose of chemotherapy typically yields an improvement in side effects while maintaining control of the cancer.

First-line chemotherapy - Chemotherapy shown to have the best probability of treating a given cancer in clinical research trials.

Second-line chemotherapy - Chemotherapy given after first line therapy has stopped working.

Palliative chemotherapy - Chemotherapy given to address a specific symptom without expecting to significantly reduce the cancer.

WHAT IS IMMUNOTHERAPY?
Immunotherapy is meant to harness the power of the immune system to help treat cancer. In general, your immune system is very good at recognizing things that are not native to your body, such as bacteria, viruses, or parasites, and destroying them. The immune system has a more difficult time detecting cancer cells because malignant cells started as a normal part of the human body. Additionally, sometimes cancer cells can secrete substances to keep the immune system response in check.
There are several different types of immunotherapy agents used routinely in modern oncology.

• Monoclonal Antibodies: These are man-made combinations of immune proteins designed to attack a very specific part of the cancer cell.
• Immune checkpoint inhibitors: These drugs take the brakes off of your immune system and help unleash the full power of the immune system on the cancer
• Cancer Vaccines: Vaccines help your immune system prevent disease, such as the flu, by starting the immune response. If you come in contact with the actual flu, then your immune system is primed to attack the virus. Cancer vaccines work the same way and help the immune system prevent cancer or prime it to attack cancer cells.

While immunotherapy is a very exciting and promising area of development in oncology, these drugs do not work in all cancer types. Your doctor can help you know if these therapies are beneficial to you.