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Combination Treatments

Combination treatments, sometimes called multimodal treatments, refer to the use of two or more kinds of therapies. Different kinds of therapies may be used in sequence, at the same time, or in various timing formats.

Combining two or more types of treatments - such as surgery, radiation, and chemotherapy - may be more effective than a single therapy alone. Under certain conditions, combination therapy not only can achieve a greater likelihood of cure than a single approach, but can do so with less damage to vital organs and tissues.

In the past, cancer treatment relied heavily on surgery, one of the oldest cancer treatment methods. For example, amputation of the affected limb used to be the only treatment for patients with osteosarcoma, a cancer of the bone found most often in young people. Now, radiation therapy directed at the tumor and chemotherapy delivered through the bloodstream may destroy the cancer without loss of the limb containing the tumor.

Due to recent advances in the treatment of early-stage breast cancer, many patients receive lumpectomy (excision of the lump) followed by radiation therapy rather than mastectomy (removal of the entire breast). This has allowed many women to retain their desired natural contour without compromising the possibility of a cure.

Treatments are combined for several reasons:

  • One treatment may be more effective at a certain stage of cancer than another.
  • One treatment may enhance the effectiveness of another synergy.
  • One treatment alone may not affect the tumor.

Depending on the stage of the disease, the oncologist will choose a primary therapy, the one that might have the most effective impact on the cancer. Then one or more other therapies may be selected to increase the possibility of cure.

To enhance the effectiveness of radiation therapy, some chemotherapy drugs are used to make certain kinds of cancer cells more susceptible to the radiation dose. Radiation therapy is generally most effective at the edges (margins) of a tumor but not as effective in the center of a tumor. Surgery can remove the tumor, but it may be unable to eliminate all cancer cells surrounding it without cutting out too much normal tissue. Therefore, the two treatments can be combined to work together, filling in the gaps of each other.

It is uncommon for cancer to be treated by only one method. With new technologies and new drugs discovered almost daily, combination treatments have shown a promising outlook for cancer treatment.