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Treating Cancer: What About Biological

Therapy?
Gintare Meizys
Independent Research 1 - G/T
02/12/2016
Ms. Julia Bakhru

Treating Cancer: What About Biological Therapy?


Gintare Meizys
Independent Research 1 - G/T

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Background: Many people seem to think that the best options for treating cancer are
chemotherapy and radiotherapy. This isnt always true. There are other options available, like
biological therapy. It has less negative impacts on the body, and some forms of it are shown to be
more effective in helping treat some forms of cancer. There are various forms of biotherapy that
are FDA-approved, and used in countries around the world, along with some cancer clinics in the
United States. In most websites, it is defined as a standard therapy, but when information is given
to patients, this therapy is often overlooked or overshadowed by chemotherapy and radiation.
Objective: This research will compare and contrast standard treatments, such as
conventional chemotherapy and radiation, with biological therapies to determine whether the
latter should be overlooked.

Introduction
Lung cancer is one of the most common cancers in the world. It can develop not only
from smoking, but from various environmental factors too. Unfortunately, lung cancer is also one
of the hardest cancers to treat. There are three standard protocols consistently followed by
oncologists in the United States of America, which are aimed at treating this cancer. These three

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include surgery, chemotherapy, and radiation ("Cancer Treatment"). Sadly, these treatments dont
work well enough, or efficiently enough, because there are still too many people dying from the
disease, or even the treatment itself. In 2012, there were 14 million new cases and 8.2 million
cancer-related deaths worldwide (Cancer Statistics). Conventional chemotherapy and
radiation sometimes have very serious side effects, which often end up exhausting and
accelerating mental and physical deterioration in patients. However, there is another type of
treatment that people arent often informed about. Biological therapy is relatively new, but
increasingly used in other countries as more and more of these drugs are approved for use. There
are various forms of biological therapy which can be used alone or in combination with other
therapies. The positive impacts of these treatments often outweigh the negatives, as compared to
the impacts of conventional chemotherapy and radiation. Doctors shouldnt overlook biological
therapy as an option for treating cancer because the efficacy, side effects, and overall quality of
life under these treatments have less of a negative impact than conventional chemotherapy and
radiation. This paper will analyze the positive and negative impacts of radiation therapy,
chemotherapy, and biological therapy for cancer, comparing them so as to understand the
importance of informing patients of all of the options they have for treatment.

Review of Literature
Biological therapy, also known as biotherapy, has few dangerous side effects, as
compared to conventional radiation therapy and chemotherapy. Conventional chemotherapy is
designed to target cells that grow and divide quickly, which is what cancer cells do. The problem
with this is that there are some very important normal cells that do the same. These may include
those in the mouth, or those lining major organs. Side effects, like mouth sores and organ
damage, occur when chemotherapy drugs affect healthy cells. Radiotherapy is designed to target

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a specific area of the body, but also produces side effects by affecting healthy cells along with
cancer cells. Both can lead to other complications, increasing the chance of death unrelated to the
actual cancer. These side effects sometimes accelerate the patients physical deterioration,
lowering their immune system, and making them prone to other illnesses. Yet, some forms of
biological therapy do just the opposite, and are designed to boost the immune system to help the
body fight cancer cells.
Side effects of biotherapy may include pain, swelling, soreness, redness, rash, nausea,
vomiting, headache, generally flu-like symptoms, and organ damage (Biological Therapies for
Cancer). However, these can be seen as fairly mild in comparison to the side effects that may
result from the other two treatments. Those of chemotherapy may include nausea, vomiting, hair
loss, pain such as headaches and numbness, burning, or tingling sensations, bone marrow
damage resulting in anemia, leukopenia, or thrombocytopenia, appetite loss, weight loss, edema,
mouth and throat sores, infection, nerve damage, muscle damage, constipation, diarrhea, mood
changes, sexual and fertility problems, permanent organ damage, osteoporosis, chemo brain,
and others (Chemotherapy Side Effects; Side Effects of Chemotherapy; Side Effects of
Chemotherapy on the Body). Radiotherapy also has a long list of potential side effects,
organized into two categories. Acute side effects include skin irritation or damage, fatigue,
nausea with or without vomiting, appetite loss, and mouth and throat problems. Skin irritation or
damage depends on the area treated, such as damage to the salivary glands, hair loss, or urinary
problems, and can be permanent. Chronic side effects include fibrosis, damage to the bowels,
memory loss, infertility, and second cancer due to radiation exposure ("Radiation Therapy for
Cancer"; Side Effects). There are many more dangerous side effects to chemotherapy and

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radiation therapy than biotherapy. Even though the latter may also develop some harsh effects,
the risk is much smaller.

There is an equal or larger chance of recovery when treatments include biotherapy, as


compared to just radiation therapy and chemotherapy. A clear, numerical chance of recovery for
any therapy is very difficult to determine because every case is different in terms of the varying
factors that affect each. Nevertheless, scientific research and other uses of biological therapy
gives reason to believe that it is one of the most promising treatments available. In some cases,
like lung cancer, it has shown improvement in overall chances of survival (Lung Cancer
Treatment).
Statistics show that Israel has a greater five-year net survival rate for lung cancer than the
United States of America (Torre). Unlike the United States, Israel lists biotherapy as a standard
treatment for lung cancer. Some hospitals in Israel describe their protocols for lung cancer, often
referring to biological therapy. One hospital even states that, [t]reatment that involves biological
therapy of lung cancer is highly promising and innovative (Herliya Medical Center). They show
dedication in treating patients with the latest and best treatment available, and this shows in the
survival rates. The U.S. seems to be stuck on the same old treatments, even though there are
others that show greater promise.
According to research conducted by scientists in Australia, cytotoxic chemotherapy does
very little to contribute to the 5-year cancer survival rate. Their data revealed that the 5-year
survival rate in Australia is over 60%, but chemotherapy has only contributed by 2.3% (Morgan).
Treatments that utilize both biological therapy and another form of therapy, like radiation,
are called combination therapies. These treatments have been proven to be even more effective
than just the use of one therapy, mostly because they work together to decrease negative side

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effects and target the cancer cells directly. Otherwise, standard chemotherapy or radiation alone
end up doing too much damage. In short, though chemotherapy drugs are particularly toxic to
cancer cells, they also damage healthy cells. The use of standard chemotherapy therefore
produces many, and often severe, side effects. Furthermore, these side effects sometimes prevent
patients from being able to take high enough doses to fight the cancer most effectively (Khuri).
For this reason, biotherapy used in combination with other therapies increases patients overall
chance of survival.
Biological therapy may not be the most effective form of treatment for each type and
stage of cancer, but it may help increase the chance of survival for some, and with the promise of
even the slightest chance of improvement it, therefore, cannot be overlooked.

Patients have a better overall quality of life when biotherapy is used to treat cancer,
whether it is in combination with other treatments or alone. Factors that contribute to quality of
life are those such as costs, chance of success, side effects and impacts. Costs affect how much
the patient or friends and family of the patient have to work to pay for treatment. It may make
life harder for those who can barely afford it. Chance of success gives an idea of whether it is
even worth trying the treatment. If chances of success are low, and side effects are numerous and
severe, treating the disease, or undergoing that particular treatment, may not be in the best
interests of the patient. Also, if chances are low, patients may not want to burden themselves or
others with the overwhelmingly high expenditures that would result from the possibly ineffective
treatments. Side effects and impacts go hand-in-hand in that they both cause problems in
everyday life, and the former may be the same as, or may cause, the latter. Impacts are defined in
this paper as long-term effects or changes in the patient's life related or unrelated to side effects.

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The overall costs of biological therapy, radiation therapy, and chemotherapy are all
similar, so in the end, they do not have much impact in deciding the differences in quality of life.
The actual, calculated medical costs of radiation therapy and chemotherapy may actually be
lower than biotherapy. However, additional costs that result from treating side effects and general
recovery from treatment must also be considered. Since both chemotherapy and radiotherapy
have many more side effects than biotherapy, it can be concluded that more money must be spent
to treat these side effects, which may include buying wigs to make up for hair loss or having
additional palliative care to reduce pain or discomfort. Palliative care often includes some form
of biological therapy, therefore increasing expenditures even more.
Impacts of treatments can be experienced mentally or physically. Some people may feel
tired or unable to function as they did before, for days, weeks, months, or even years after
chemotherapy or radiation therapy (Mood Changes). Hair loss and other damages or changes
in the body also have been known to cause self esteem issues and insecurity, and many patients
experience depression, anxiety and paranoia following treatment. [A] 2014 survey conducted by
the Cancer Support Community, a national nonprofit network, revealed that almost half of the
7,000 patients they polled were riddled with anxiety because of financial concerns, while about a
third drained savings or tapped retirement accounts to pay for care (Marsa). Paranoia stems
from fear that the cancer will return, or that another cancer will develop. With biological therapy,
there is much less of a chance of developing a second cancer. There is only one type of biological
therapy that is known to directly cause secondary cancer, but this does not come from the
substance used for treatment itself, but due to an error in the procedure which has very low
chance of occurring. Even so, researchers are working on removing this possibility (Biological
Therapies for Cancer). Radiation therapy has the greatest risk with developing a second cancer

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years after treatment because radiation itself is a known carcinogen, and treatment does not only
affect cancer cells, but often comes in contact with healthy cells. Impacts may also include other
forms of cancer developing years after treatment. Compromised immune system is another
impact due to chemotherapy and radiotherapy, which leaves survivors more susceptible to death
from other illnesses. All of the side effects and impacts of treatment that affect the individuals
state of mental or physical being, affect their ability to work and provide for their family, to
communicate and interact with others, and to generally enjoy life, affect their everyday lives.
With this, the quality of life under and after treatment is affected.
Biological therapy in combination with another therapy has a greater overall chance of
survival, and less side effects and impacts during and after treatment, along with lower additional
costs, as compared to radiation therapy or chemotherapy alone.
There are many advantages to biological therapy that are not being used as they should.
These include fewer and often less dangerous side effects, higher chance of success when used in
combination with other forms of treatment, and better overall quality of life. In some cases,
radiation therapy or chemotherapy may be the best option and should not be replaced with
biotherapy. However, in other cases, biological therapy or a combination of biotherapy and other
therapies may be the best options. For this reason, biological therapy should not be overlooked
by doctors and patients. People should be informed of all the options they have, and biotherapy
should more often be considered for primary treatment of cancer. Chemotherapy and radiation
are not the only treatments available, and should not be treated as such.

Research Methods and Data Collection


The data collected and further analysis will address the question: between chemotherapy,
radiotherapy, and biotherapy, which of these treatments has the least risk of pain or discomfort

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involved? The hypothesis to this question is that biological therapy has the least risk involved.
Qualitative data will be gathered through interviews, already-existing research and scientific
trials, and analysis of treatment descriptions and their mechanics. The data for each treatment
will be recorded in a data collection notebook and compared evaluating the risks and effects of
each. Each side effect will also be ranked according to occurrence for each treatment.
Occurrence data will also be gathered through treatment descriptions and already-existing
research. The ranks are common, moderate, and uncommon. This information will be
organized into a chart to visually display the gathered data.

Results and Data Analysis


The following charts each contain the side effects and occurrence of the three different
treatments. Biotherapy has several separate charts for a few of the more common types of the
therapy. There will be a brief explanation after each chart.

Chemotherapy:
Side Effects

Occurrence

Mood changes

Common

Nausea, vomiting

Common

Flu-like symptoms

Moderate

Hair loss

Common

Fatigue

Common

Pain: Feeling burning, tingling or


numbness; headaches

Common

Infection

Common

Bone marrow damage: anemia,


leukopenia, thrombocytopenia

Common

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Appetite loss: weight loss, not enough
nutrition

Common

Mouth sores, throat sores

Common

Nerve damage, Muscle damage

Common

Skin and nail changes or problems

Common

Urine, bladder, and kidney changes or


problems: constipation, diarrhea

Common

Trouble focusing or thinking clearly

Common

Sexual and fertility problems: harms


unborn fetus, affects ability to carry a
child, affects ability to get
pregnant/impregnate

Common

Permanent or long-term organ damage

Moderate

Osteoporosis

Moderate

Second cancer

Common

Most of the side effects listed for chemotherapy are common. This means that there is a
very good chance that someone under chemotherapy will experience a few of these, if not all.
The chance of these side effects occurring may also increase when in combination with
radiotherapy ("Chemotherapy and Cancer Treatment, Coping with Side Effects."). Other than
flu-like symptoms, the only side effects that are less common are permanent or long-term organ
damage and osteoporosis. Flu-like symptoms occur and last from hours to days after treatment,
and the chance of this happening increases when chemotherapy is used with biotherapy ("Cancer
Treatment Side Effects: Flu-Like Symptoms" ).

Radiotherapy:
Side Effects

Occurrence

Mood changes

Common

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Nausea, vomiting

Common

Hair loss

Common

Fatigue

Common

Bone marrow damage: anemia,


leukopenia, thrombocytopenia

Uncommon

Tooth decay

Uncommon

Appetite loss: weight loss, not enough


nutrition

Common

Skin irritation or damage

Common

Fibrosis

Uncommon

Damage to the salivary glands

Common

Urinary problems, damage to the bowels

Common

Memory loss

Uncommon

Trouble focusing or thinking clearly

Uncommon

Sexual and fertility problems: harms


unborn fetus, affects ability to carry a
child, affects ability to get
pregnant/impregnate

Moderate

Permanent or long-term organ damage

Moderate

Second cancer

Common

Radiation therapy is usually directed towards one specific part of the body so that it
affects the least amount of healthy cells. This means that some side effects are dependant on
where the radiation is aimed. Some side effects listed as uncommon are those that are associated
more with specific parts of the body. Trouble focusing or thinking clearly, as well as memory
loss, are more common with brain radiation. Tooth decay is more common with mouth radiation.

Biotherapy:
MAbs:

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Side Effects

Occurrence

Fatigue

Common

Flu-like symptoms

Common

Allergic reaction

Moderate

Lowered blood counts

Uncommon

Changes in blood chemistry

Uncommon

Organ damage (heart, kidneys, liver,


brain)

Uncommon

MAbs stands for monoclonal antibodies. They are antibodies that are produced in laboratories.
They target cancer cells and bind to them, triggering the immune system to find these cells and
destroy them. Only two side effects, fatigue and flu-like symptoms, are common.

Cytokines:

Side Effects

Occurrence

Fatigue

Common

Flu-like symptoms

Common

Allergic reaction

Moderate

Lowered blood counts

Uncommon

Changes in blood chemistry

Uncommon

Organ damage (heart, kidneys, liver,


brain)

Uncommon

Cytokines are proteins that signal the immune system to respond to cancer cells and help
promote their destruction. Like MAbs, Cytokines only have two common side effects.

Treatment Vaccines:

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Side Effects

Occurrence

Fatigue

Common

Flu-like symptoms

Common

Allergic reaction

Moderate

Cancer treatment vaccines use cancer-associated cells to trigger immune response to cancer cells.
They only have three possible side effects, two of which are common.
BCG:

Side Effects

Occurrence

Fatigue

Common

Flu-like symptoms

Common

Allergic reaction

Moderate

BCG Infection Reaction

Uncommon

Urinary problems: pain or burning


sensation, increased frequency of
urination, blood in the urine

Common

BCG stands for Bacillus Calmette-Guerin. It is used to stimulate an immune response against
cancer cells. Three side effects: fatigue, flu-like symptoms, and urinary problems, are common in
this treatment.

A quick glance at each table shows that chemotherapy and radiotherapy both have a similar
number of possible side effects, this number being much larger than the possible side effects for
any of the biological therapies. Not only are there more possible side effects for chemotherapy
and radiation therapy, many of these side effects are common, and therefore more likely to occur.

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In conclusion, out of the three treatments reviewed, biological therapy has the least risk of pain
or discomfort.

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