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  • Cancer treatment plans vary depending on type and stage of cancer

    Patients who receive a cancer diagnosis typically share the news with family and friends. Those friends and family in return, often share their own cancer experience or the experiences they have heard from other friends. It’s just human nature to compare those experiences, which can sometimes lead to confusion as to the differences in cancer treatment plans.
    Radiation Oncologist Michael Fallon, MD, MBA, of Rome Memorial Hospital Radiation Medicine at Chestnut Commons, explains that not all cancers are the same, so not all cancer treatments are the same either. Cancer treatment plans are developed based upon each individual patient’s diagnosis. Providers take into account the latest cancer guidelines for treatment and also the risks and benefits to the patient for each type of cancer treatment.
    Cancer treatment may include surgery, chemo therapy and radiation therapy individually or in various combinations. Consultations with three cancer specialists, a surgeon, medical oncologist and radiation oncologist, are recommended as soon as possible upon receiving a cancer diagnosis. Studies have shown that cancer care coordination approaches have led to improvements in treatment outcomes, according to Institute of Medicine.
    Coordination between these experts in cancer care can lead to reduced time in beginning treatment, as well as the most informed decisions in the type of treatment that is best for each patient.
    According to Dr. Fallon, determining factors for cancer treatment include where the cancer originated and what stage the cancer is.
    “The most commonly diagnosed cancer in the United States originates in the lung (lung cancer); the second most common starts in the colon or rectum (colorectal cancer),” Dr. Fallon said. “Breast cancer is the most common site of cancer in women, with just over 200,000 new cases diagnosed each year, while the prostate cancer is the most frequently diagnosed cancer in men.”
    “The American Joint Commission on Cancer (AJCC) has well defined stages for each type of cancer,” Dr. Fallon continued. “The stage for an individual’s cancer can range from stage zero to stage four and represents the overall extent of the disease process.”
    Dr. Fallon said traditionally, the stage of any cancer is based on the size of the tumor, the presence or absence of cancer cells in adjacent lymph nodes, and the possible spread of cancer to other organs of the body. This staging system is known by the acronym of TNM for T (Tumor) N (Nodes) M (Metastasis). More recently, the AJCC Staging System has incorporated certain biologic factors into its staging algorithm, such as estrogen status for breast cancer and immune markers for lung cancer and melanoma.
    “The stage of a person’s cancer is important for a number of reasons,” Dr. Fallon said. “It will help determine the best possible course of treatment for that particular cancer. Early stage cancers many only require a limited surgical procedure or a course of radiation; more advance stages may dictate extensive surgery with either radiation or chemotherapy (or both) before or after surgery.”
    Dr. Fallon said that a standardized definition of the stage of any person’s cancer provides a uniform “language” for different cancer care providers when discussing a person’s treatment options along with the associated risks and benefits of any given treatment. Such information is critical to that patient’s decision making process.
    Catching cancer in a lesser stage when it is more easily treatable is the objective of cancer screening procedures, such as mammograms for breast cancer, pap smears for cervical cancer, colonoscopies for colorectal cancer, skin surveys for cancers of the skin, and low dose CT scanning for lung cancer, for those who qualify.
    “By participating in these screening protocols, individuals can decrease their risk of dying from these types of cancer,” Dr. Fallon explained. “More recently, considerable progress has been made in genetic screening, which analyzes an individual’s gene “profile” to predict that person’s risk of developing cancer over the course of his/her lifetime. Both forms of screening allow for proactive approaches to the prevention, early intervention, and potential cure of cancer.”
    Hereditary cancer risk screening is now available to Dr. Fallon’s patients at Rome Memorial Hospital Radiation Medicine as well as at the Women’s Imaging Center at the hospital. Patients are asked to fill out a questionnaire about their family history of cancer. Those who qualify, based upon their family history, are screened for 28 genetic mutations that impact hereditary risk for eight cancers including breast, ovarian, gastric, colorectal, pancreatic, melanoma, prostate and endometrial.
    For patients already undergoing treatment for one kind of cancer, this screening will determine if they are at increased risk for other cancers and if they have genetic mutations which may have played a role in the development of the cancer they are being treated for. This information is important not only for the patient, but also for their family members, who may want to pursue their own hereditary cancer risk screening to determine if they are also at higher risk do to their genetic profile.
    To schedule a consultation with Dr. Fallon, please call Rome Memorial Hospital Radiation Medicine at 315.338.0897.
     Fallon, Michael 
    Michael Fallon, MD, MBA