Beyond chemotherapy: the evolution of cancer care

Breast Cancer Awareness Month is a time to recognize how far cancer care has come and how much continues to change.

Advances in chemotherapy, targeted therapies and other treatments have helped improve outcomes for cancer patients, giving many the opportunity to live long, healthy lives after their diagnosis.

As treatments have advanced, so has our understanding of the potential effects they can have beyond the cancer itself. Some therapies can affect the cardiovascular system, making heart health an important part of cancer care. Cardio-oncology brings these two areas of medicine together, helping doctors monitor and manage heart health before, during and after cancer treatment.

For patients and their loved ones, understanding how cancer treatment has evolved, including what treatments are available, what to expect and how they may affect the body, can provide valuable information as they navigate their care. Looking at how far cancer treatment has come also helps put today’s options and approach to care into perspective.

How Have Cancer Therapies Evolved?

Cancer treatment has come a long way since chemotherapy was first introduced in the 1940s. While chemotherapy remains an important part of treatment for many cancers, today’s approach is much more individualized and may include a combination of therapies based on the type of cancer, its genetic characteristics and how it responds to treatment.

Over the past 20-plus years, the U.S. Food and Drug Administration (FDA) has approved a variety of new cancer therapies, giving oncologists more options for treating the disease. These include targeted therapies, which are designed to act on specific proteins or molecular changes that help cancer cells grow and spread, as well as immunotherapies that help the immune system recognize and treat cancer cells.

Chemotherapy is no longer a one-size-fits-all treatment. Depending on the cancer, patients may receive chemotherapy alone or in combination with other medications. Researchers also continue to study different drug combinations and treatment sequences to determine which approaches may provide the greatest benefit for individual patients.

Another major advancement has been the ability to match certain treatments to the biology of a patient’s tumor. Some newer therapies are approved based on specific genetic or molecular characteristics of a cancer rather than simply where the cancer started in the body. This approach, known as precision or tumor-agnostic therapy, represents a significant shift in how some cancers are treated.

Today, the landscape of cancer treatment includes hundreds of approved drugs and drug combinations, ranging from traditional chemotherapy to targeted therapies, immunotherapies and cellular therapies. The field continues to evolve as researchers identify new ways to attack cancer while finding ways to make treatment more precise and effective.

Understanding Modern Chemotherapy

For generations, the word “chemotherapy” has been closely associated with cancer care, but the chemotherapy patients receive today can look very different from the treatments used decades ago.

Chemotherapy is rarely used as the only modern treatment option. Depending on the type and stage of cancer, it may be combined with surgery, radiation, targeted therapies or immunotherapy. Oncologists can also use information about a patient’s specific cancer to help determine which treatments are most appropriate.

The origins of chemotherapy can be traced to researchers studying the effects of mustard gas exposure on soldiers. They observed that the chemical severely affected rapidly dividing cells, including cells in the bone marrow. This discovery helped lead to the first clinical use of nitrogen mustard as a cancer treatment in 1942.

Early chemotherapy was often given with the goal of killing cancer cells as quickly as possible. Because chemotherapy drugs can also affect some healthy cells that divide rapidly, patients could experience significant side effects, including nausea, fatigue, hair loss and lowered blood counts.

Since its early days, researchers have developed new medications, improved dosing strategies and found ways to combine different drugs to make treatment more effective while helping manage side effects. Supportive medications have also made it easier for patients to tolerate treatment and maintain their quality of life during therapy.

Today, chemotherapy may be combined with targeted therapies or immunotherapy, with treatment increasingly tailored to the biology of each patient’s cancer. Specialists can also monitor and manage the effects cancer treatment may have on other vital organs, including the heart.

Can Chemotherapy Affect the Heart?

Having a cardio-oncologist as part of the patient’s care team can help identify and manage these potential effects while allowing patients to continue receiving the cancer treatment they need.

A cardio-oncologist works closely with a patient’s care team to identify cardiovascular risk factors, establish a baseline of heart health and monitor for changes before and during treatment. Depending on the patient and the treatment being used, this may include testing before treatment begins and ongoing monitoring throughout therapy.

If a concern develops, the cardio-oncology team can work with the cancer team to determine the best way to address it. This may include treating a cardiovascular condition, adjusting medications or, when appropriate, modifying the cancer treatment plan.

The goal is not simply to protect the heart, but to help patients receive the most appropriate cancer treatment as safely as possible while supporting their overall health.

Convenient, Local and Comprehensive Cancer Care

Having these services available in one location can make an important difference for patients and their families. Cancer treatment can involve numerous appointments, tests and specialists, and having comprehensive care and supportive services nearby can make it easier for patients to receive the care they need in their own communities, surrounded by friends and loved ones. It also allows care teams to communicate and coordinate more closely throughout treatment.

For those facing breast cancer and other types of cancer, these advances offer more than new treatment options. They represent a broader approach to care that focuses not only on treating the disease, but on protecting the heart, supporting the whole person and helping patients live well beyond treatment.

New Lee Health at Veterans Parkway to Offer State-of-the-Art Oncology Services

Slated for late 2027, Cape Coral and Pine Island residents and visitors will have convenient access to comprehensive diagnostic, treatment and surgical services at Lee Health at Veterans Parkway.

The state-of-the-art facility will expand access to advanced imaging, infusion therapy, surgical and interventional services, and specialty care, including cardiology, musculoskeletal and oncology services — all within a coordinated setting close to home.

For patients receiving cancer treatment, the facility will feature an advanced Infusion Center with 24 stations, including private options, and a dedicated Infusion Pharmacy to support chemotherapy and other intravenous therapies. The space is designed to provide a comfortable, coordinated setting for patients receiving treatment.

The facility also will offer robust surgical and interventional services, including four operating rooms, two catheterization labs, two electrophysiology (EP) labs, and 28 pre- and post-operative recovery rooms.

To learn more about chemotherapy and other cancer treatments, cardio-oncology, cancer care, or to schedule an appointment with a provider, please visit www.leehealth.org.

Tina Gegeckas is the Director of Pharmacy – Oncology for Lee Health

TINA GEGECKAS