The Newest Methods In Cancer Treatment
From Georgia to Serbia and Holland, from Moldova to Egypt and Iraq, about 100 oncology specialists and surgeons from 25 countries listened to Turkish doctors and shared their experiences at the 2nd Acibadem International Oncology Meeting.
The doctors, that attended the oncology meeting at the Acibadem Maslak Hospital, also had the opportunity to observe robotic surgery, Cyberknife and port applications.
While providing patients with the newest methods in cancer diagnosis and treatments for the past 10 years, Turkey also continues to draw interest with great achievements in recent years. When the success of its doctors were combined with the newest technological devices, Turkey has become a country that patients in neighboring countries have come to prefer. In fact, Turkish doctors not only treat patients who come to our country, but they also share their knowledge and experience with doctors in other countries. The “Acibadem International Oncology Meeting”, organized for the 2nd time at the Acibadem Maslak Hospital, has become one of these occasions for learning. At the conference, the Acibadem Healthcare Group doctors shared the latest developments in gynecological, breast, head and neck and stomach cancers with colleagues from abroad to seek the answer to the question “how can we treat patients better?” At the 2-day Acibadem International Oncology Meeting, the oncology specialists and surgeons from 25 different countries like Georgia, Serbia, Egypt, Iraq, Holland and Moldova received information from Turkish doctors.
IN GYNECOLOGICAL CANCERS
The medications in recurring gynecological cancers double life span without disease
Acibadem Maslak Hospital Medical Oncology Specialist Prof. Dr. Özlem Er emphasized the importance of a multidisciplinary approach at the conference and pointed out the life extending role of target based treatments in addition to chemotherapy especially in gynecological cancers. Medical Oncology Specialist Prof. Dr. Özlem Er also added that when the medications being used for over a year in our country that impact tumor veins are added to chemotherapy, especially in recurring ovarian, cervical and uterine cancer, the lifespan without disease can practically be doubled. Prof. Dr. Özlem Er also touched on the importance of separating ovarian cancers into sub-types and said “Ovarian cancer is actually not a single type of cancer. There are 5-6 types of this cancer and each one responds differently to treatment. Presently ovarian cancers can be separated into sub-types and thus a different treatment is applied to each patient. Customized treatment provides a more comfortable life for the patient and also extends their life span”.
Robotic surgery prevents serious complications
In the past, gynecological cancer operations were done through a 25-30 centimeter incision in the abdomen. When a large incision is made in the abdomen, the recovery period can take up to one month. If an incision related infection occurs, this period can exceed two months. When the recovery period is delayed, patients miss the opportunity to get chemotherapy and radiotherapy in the early stages. In the last 10 years, especially in intrauterine cancers and uterine cancers, almost all of the operations have been done by robotic surgery, a method which is rapidly becoming more popular throughout the world. Three dimensional robotic surgery is done by entering the abdominal cavity through 4-5 incisions in the abdomen, the largest of which is only one centimeter.
Acibadem Maslak Hospital Gynecology and Obstetrics Specialist Prof. Dr Mete Güngör explained that performing robotically-assisted gynecological operations provides great advantages to patients, and listed them as follows: “Robotic surgery provides patients with less pain, less blood loss, less complications, smaller scars, less time spent in hospital and the ability to return to their daily lives faster. For example, the short period of recovery needed following robotic surgery and the occurrence of infection being very rare enable radiotherapy and chemotherapy to be started within one week. It is also stated in the literature that the curing capacity of robotic surgery is much higher than open surgery. Also during radiotherapy applied after open surgery, there can be complications like adhesions in the tissues and damage in the intestines. These types of complications do not develop in robotic surgery because there is no open incision”.
IN BREAST CANCER
Radiotherapy treatment is completed in 3 weeks
One of the fields of cancer treatment that has been developing rapidly, regarding technology, in recent years is radiotherapy. Currently radiotherapy treatment is applied as local treatment to all patients who have preventive breast surgery, or in other words only have the tumor removed, and leave the rest of the breast intact. However, until recently, radiotherapy in all patients took 6-6.5 weeks and patients would have to go to the hospital every day of the week except the weekends. Acibadem Maslak Hospital Radiation Oncology Specialist Assoc. Prof. Dr. Banu Atalar pointed out the “hypofractionation” method used in some early stage breast cancer, patients could reduce the total treatment time to 3 weeks, and added “In fact, the technological advancements enable the heart to be kept safe during left breast radiotherapy, side effects are minimized and excellent cosmetic results are achieved”.
Single dose radiotherapy can be applied during surgery
Another important development in breast cancer treatment is that through intraoperative radiotherapy patients at early stages and a suitable age can receive radiotherapy with a single dose during the operation using an LIAC device. Radiation Oncology Specialist Assoc. Prof. Dr. Banu Atalar said, “An important advantage is provided to patients with this method by eliminating the wait for the incision to heal after surgery and the requirement to come to the hospital every day for treatment,” and added: “Also being able to administer a single dose during the operation to reduce the treatment time is another important advantage for the patient.”
IN HEAD AND NECK CANCERS
The most striking subject in head and neck cancers was the “blood test that determines virus burden” which is used in treating nasal cancer. Acibadem Maslak Hospital Radiation Oncology Specialist Prof. Dr. Enis Özyar explained that with this test, depending on the rate of EBV DNA substance in the blood, which shows tumor burden, it can be determined whether or not the disease is aggressive and therefore a treatment can be planned accordingly. He added: “For example if the level of EBV DNA substance in the blood is high, a more concentrated dose of chemotherapy is administered. If the opposite is in question, the patient is not given unnecessary chemotherapy or radiotherapy after surgery.”
Tumors can now be removed through the nose
Another development that was emphasized at the conference was the method of removing a tumor through the nose, instead of opening the cranium. In this technique, the coordinates are determined in 3 dimensions and a special device is used to enter through the nose and remove tumors in this area. This method prevents unnecessary treatments like opening the patient’s cranium, and thus enables them to leave the hospital sooner.
IN STOMACH CANCERS
Simultaneous radio-chemotherapy is on the agenda
While the main treatment for stomach cancer is surgical, the survival rates are not very optimistic with this method alone. Acibadem Maslak Hospital Radiation Oncology Specialist Prof. Dr. Nuran Beşe pointed out that this was the reason studies were being conducted on adding pre and post treatment radiotherapy and chemotherapy and added: “Especially patients, whose lymph nodes have not been sufficiently cleaned out, benefit from post operative chemotherapy and simultaneous chemotherapy and radiotherapy. If, despite sufficient amounts of lymph nodes being removed, disease has spread to the lymph node, these patients can also benefit from simultaneous radio-chemotherapy. In local advanced cases, performing surgery after administering chemotherapy provides better survival rates compared to patients who are only treated surgically. The role of radiotherapy in the lymph node positivity of these patients after chemotherapy is still being researched. Presently administering radiotherapy using more advanced technology provides significantly more comfort to patients in terms of side effects and the side effects observed in the past in simultaneous chemo-radiotherapy are seen less frequently today”
“Hot chemotherapy” to prevent recurrence
In recent years, minimal invasive methods like laparoscopic and robotic surgery are preferred in treating stomach cancer. Acibadem University Atakent Hospital General Surgeon Prof. Dr. Bilgi Baca spoke at the meeting about the important advantages to robotic surgery, regarding less bleeding, less infection risk, less pain and the ability to leave the hospital sooner and go back to normal life, and listed other benefits as follows:
“In addition to these advantages, compared to laparoscopic surgery, we can remove lymph nodes more effectively and safely by robotic surgery. Also we can see important structures like arteries and organs like the pancreas more clearly. Thus, there is less risk of damaging any organs.” Prof. Dr. Bilgi Baca, who pointed out that stomach cancer is usually diagnosed late in our country, said “When this cancer is diagnosed in late stages, the rate of recurrence increases. In order to prevent the recurrence of the disease, the stomach is washed out with heated chemotherapy before the tumor has spread to the abdominal cavity in patients whose cancer is diagnosed at a later stage. Although there is no scientific data on this yet it is expected that this method will reduce the rate of recurrence.”