Cancer treatment has evolved significantly over recent decades and is now based on a multidisciplinary and increasingly personalised approach. Treatment selection depends on several factors, including the type of cancer, its stage, the tumour's molecular characteristics, the patient's overall health and personal preferences. In many cases, a combination of treatments is used to achieve the best possible outcome.

Local Treatments

Local treatments target a specific area of the body where the tumour is located.

1. Surgery

Surgery involves the removal of the tumour and, in some cases, nearby tissues or lymph nodes. It remains one of the most important treatments for many solid tumours, particularly when the cancer is localised and can be completely removed.

Surgery may be used for different purposes:

  • Curative treatment (removing all cancer).
  • Diagnostic purposes (obtaining a biopsy).
  • Determining the extent of the disease.
  • Relieving symptoms caused by the tumour (palliative surgery).
  • Reconstruction following tumour removal.

2. Radiotherapy

Radiotherapy uses high-energy ionising radiation to destroy cancer cells or prevent them from multiplying. Thanks to modern technological advances, treatments are now much more precise, allowing high doses to be delivered to the tumour while minimising exposure to surrounding healthy tissues.

Radiotherapy may be used:

  • As the main treatment.
  • Before surgery (neoadjuvant treatment).
  • After surgery (adjuvant treatment).
  • In combination with chemotherapy or other treatments.
  • To control symptoms in advanced disease.

Systemic Treatments

Systemic treatments act on cancer cells throughout the body and are particularly important when there is a risk of cancer spread or metastatic disease.

1. Chemotherapy

Chemotherapy uses drugs that can destroy cancer cells or stop their growth. Although some treatments may also affect healthy rapidly dividing cells, advances in the management of side effects have significantly improved treatment tolerability.

Chemotherapy regimens are selected according to:

  • The type of cancer.
  • The stage of the disease.
  • The biological characteristics of the tumour.
  • The patient's clinical condition.

2. Hormone Therapy

Some tumours depend on hormones for growth. Hormone therapy works by reducing hormone production or blocking the action of specific hormones on cancer cells.

It is mainly used in:

  • Hormone receptor-positive breast cancer.
  • Prostate cancer.
  • Certain gynaecological cancers.

3. Targeted Therapies

Targeted therapies act on specific molecular alterations that promote the growth and survival of cancer cells.

Unlike conventional chemotherapy, these treatments are designed to target specific abnormalities identified through genomic testing or tumour biomarker analysis.

Examples include therapies targeting:

  • HER2.
  • EGFR.
  • ALK.
  • BRAF.
  • VEGF.

These are just a few of many molecular targets currently available.

4. Immunotherapy

Immunotherapy represents one of the most important advances in modern oncology. Its aim is to enhance or restore the immune system's ability to recognise and destroy cancer cells.

It is now a standard treatment for many cancers, including some lung cancers, melanoma, kidney cancer, bladder cancer, and head and neck cancers.

Main forms of immunotherapy include:

  • Immune checkpoint inhibitors (PD-1, PD-L1 and CTLA-4 inhibitors).
  • Cellular therapies, such as CAR T-cell therapy for certain haematological malignancies.
  • Other immunomodulatory treatments.

Other Treatments and Supportive Strategies

Haematopoietic Stem Cell Transplantation

This treatment may be used in selected cases of leukaemia, lymphoma and multiple myeloma to replace damaged bone marrow following intensive treatment.

Precision Medicine

Current international guidelines recommend molecular biomarker and genomic testing when appropriate. This enables clinicians to select more effective and personalised treatment strategies.

Supportive and Palliative Care

Supportive and palliative care are integral components of cancer treatment from the time of diagnosis. These services include:

  • Pain and symptom management.
  • Nutritional support.
  • Psychological support.
  • Rehabilitation.
  • Specialist palliative care when required.

The aim is to improve quality of life at every stage of the disease.