Medical oncology

Chemotherapy works by disrupting the cell cycle.¹⁰ Each time a new cell forms it goes through a series of phases in order to become mature.¹¹ Chemotherapy medicines target the different phases of the cell cycle.¹⁰ By disrupting or stopping a particular phase, a cancerous cell can no longer mature and divide and ultimately dies.¹⁰

Some cancers make use of your body’s own hormones to grow and multiply.⁷ These cancers are known as ‘hormone dependent’ cancers and include some types of breast, uterine and prostate cancers.¹² Hormone therapy uses medicines to block the body’s own hormones, e.g. testosterone in men and oestrogen in women.⁷ By stopping or lowering the amount of hormones the tumour receives, the growth of the cancer can be slowed.⁷

Your immune system is designed to protect your body from threats such as infections, toxins and abnormal cell development (cancer).^8,13 While your immune system can help to prevent or slow cancer growth, cancer cells have ways to avoid detection and destruction by immune cells.⁸ Immunotherapy medicines boost or improve how your own body’s immune system works to fight cancer.⁸ Immunotherapy medicines work in different ways and include:

• Checkpoint inhibitors:These medicines take the ‘brakes’ off the immune system, which helps it to then recognise and attack cancer cells.^8,13
• Chimeric antigen receptor (CAR) T-cell therapy: T-cells from a patient’s blood are mixed with a special virus that makes the T-cells learn how to attach to tumour cells.  These cells are then given back to the patient so they can find, attach to, and kill the cancer.^8,13
• Cytokines: Cytokines are small proteins that carry messages between cells. They are used to stimulate the immune cells to attack cancer.¹⁴
• Immunomodulators: Boost parts of the immune system to treat certain types of cancer.⁸
• Cancer vaccines: Vaccines are being researched and developed with the aim of preventing or treating cancer through an immune response.⁸
  

Targeted therapies work by finding a specific target on cancerous cells that they can attack or block to stop the cells from making new cancer cells.^9,15 If your cancer type is known to have a target, it will be tested at the time of your biopsy or surgery to see if the target is present.⁹ Assuming it is, a targeted therapy may form part of your treatment plan. As these medicines have a targeted action to the cancer cell, the damage to normal cells is usually reduced, but this does not mean that targeted therapies are free of side-effects.^9,15

Some types of targeted therapies include but are not limited to:

• Angiogenesis inhibitors: Block the formation of new blood vessels to the tumour so that the tumour is deprived of nutrients.⁹
• Monoclonal antibodies: Deliver molecules to the target on the cancer cell which then interfere with the cell’s ability to signal and divide.⁹
• Signal transduction inhibitors: Block the signals passed from one molecule to another inside a cell.  By blocking the signals, the cell cannot function properly and its ability to divide is affected.⁹