What is chemotherapy? Chemotherapy is medication that fights tumors by focusing on fast-dividing cells, a key trait of cancer cells. It acts on all fast-dividing cells, however, so it can also damage normal cells.

How does it work? Different medications work in different ways. Some prevent cancer cells from dividing, for example, while others trigger cells to self-destruct. Most patients receive a combination of medications, called a regimen, to take advantage of these different approaches.

How is it given? Most often, chemo medications are delivered in an IV drip called an infusion. Patients often receive chemo as outpatients in two- or three-week cycles with time off to recover. The number of cycles depends on your treatment plan.

When is it used? Chemotherapy can be given before or after surgery, or to manage symptoms of advanced cancer.

• Before surgery (neoadjuvant chemotherapy): This chemo is given to shrink a tumor so that a patient needs less surgery, or to reduce a tumor so it’s small enough to remove in surgery. It can also help your doctor identify which medications work best on your cancer. 
• After surgery (adjuvant chemotherapy): This chemo is given to kill any cancer cells that may remain after surgery. It reduces the risk that cancer will come back or spread to another part of your body. 
• For advanced cancer (palliative chemotherapy): This chemo may be given to shrink or slow the growth of tumors or to control symptoms of cancer that has spread to other organs or tissues. 

What are targeted therapies? Targeted therapy is a newer type of chemotherapy that uses medication to affect specific molecules (targets) in cancer cells. This makes it less likely to affect normal cells or cause side effects.

Targeted therapies are often used to treat breast cancer, colon cancer, lung cancer and aggressive skin cancer. Discoveries by Knight Cancer Institute's Brian Druker, M.D. also led to the development of Gleevec, a targeted therapy that turned a deadly cancer, chronic myeloid leukemia, into a manageable condition.

How do they work? They attack cancer cells in different ways. Depending on your condition, you might have a targeted medication that acts on genes or proteins in your body to:

• Block the signals that tell cancer cells to grow and multiply. 
• Starve cancer cells or disrupt cell functions. 
• Help other treatments work better by disrupting cancer cells. 

How are they given? Targeted therapies may be given intravenously or by mouth. They are often combined with other cancer treatments. The length of your treatment will depend on your cancer’s type and stage. For example, early-stage breast cancer patients who receive a common type of targeted therapy get infusions once every three weeks for a year.

When are they given? Like chemotherapy, targeted therapies can be given:

• Before surgery, to shrink a tumor. 
• After surgery, to lower the risk of cancer returning. 
• For advanced cancer, to slow growth. 

What is hormone therapy? Hormone therapy is medication that treats cancers that use hormones to grow, such as breast cancer and prostate cancer. It’s usually combined  with other treatments.

How does it work? Hormone therapy works in two main ways. It blocks your ability to produce hormones, or it interferes with how your hormones behave.

It can keep cancer from growing and spreading by acting on substances called cell receptors. Receptors are proteins on the surface of cancer cells that attach to certain hormones and medications.

When your hormones bind with cancer cell receptors, they act like a key fitting in a lock. The can give the cells instructions to divide and grow. Most hormone therapies work by blocking the receptors — like jamming the lock — or by lowering the level of cancer-activating hormones in your body.

How is it given? Hormone therapy may be given by mouth, in a shot or implanted under the skin. In some cases, patients may have surgery to remove hormone-producing organs such as the ovaries or testicles.

How often you get treatment will depend on your condition. Some patients take daily pills at home. Others may have monthly shots at a doctor’s office or hospital.

When is it given? Like chemotherapy, targeted therapies can be given:

• Before surgery, to shrink a tumor, though this is uncommon. 
• After surgery, to lower the risk of cancer returning. 
• For advanced cancer, to slow growth.

What is immunotherapy? Medications that boost your immune system’s natural ability to fight tumors are called immunotherapies. Compared with traditional chemotherapy, immune-based approaches may lead to longer-lasting improvements. They also may increase survival times in people with certain aggressive cancers.

Advances: Immunotherapies, offered at the OHSU Knight Cancer Institute, have led to several new ways to treat cancer. Our experts are working to make immunotherapy treatment available to more patients and for more cancer types.