Systemic anti-cancer therapies (SACT) at HCA UK

Systemic anti-cancer therapies is the collective term for a group of drugs used to treat or control cancer. This includes chemotherapy, hormone therapies, targeted therapies, immunotherapies, adoptive cellular therapies and bispecific antibodies. You may receive one therapy on its own or a combination, depending on your individual diagnosis. 

These treatments can be given in different ways: intravenously into your bloodstream, taken orally as tablets or delivered as an injection. Your team will talk you through the treatment that has been recommended to you and answer any questions you might have before you begin treatment.

Based on your diagnosis, for example the type and stage of your cancer, your team may recommend systemic anti-cancer therapies (SACT) either on their own or alongside other treatments, such as surgery or radiotherapy. We offer the full range of treatment options – from well-established therapies like chemotherapy to the latest immunotherapies, targeted treatments and hormone therapies, so you can be assured we can provide the treatment that’s right for you.

How systemic anti-cancer therapies may be used:

Adjuvant therapy – This is when systemic anti-cancer therapies are given after surgery or radiotherapy to target any remaining cancer cells and reduce the risk of the cancer returning.

Neoadjuvant therapy – This is when systemic anti-cancer therapies are given before surgery to help reduce the size of the tumour and reduce the risk of the cancer returning. 

Metastatic cancer treatment – This is when systemic anti-cancer therapies are used to control cancer that has spread to other parts of the body, aiming to control cancer growth and manage symptoms.

Your consultant will explain why SACT is being recommended, what it involves and any potential side effects. Together with your named clinical nurse specialist, they’ll be on hand to answer your questions and support you in making informed decisions about your care.

Your consultant may recommend genomic testing to learn more about the genetic behaviour of your cancer and how it may respond to different therapies.

Genomic testing, also referred to as molecular diagnostics, analyses the genetic profile of your tumour to identify specific changes that can help guide the most effective treatment for your individual cancer.

Chemotherapy uses anti-cancer drugs to destroy cancer cells or control their growth. Depending on your diagnosis and individual circumstances, you may receive a single chemotherapy drug or a combination of drugs designed to work together.

Chemotherapy can be used on its own, or alongside other treatments such as surgery, radiotherapy or immunotherapy. 

There are several ways chemotherapy can be given: 

Common methods

• Intravenous (IV) drip/infusion: This is the most common method, where treatment is carefully infused into your bloodstream through a cannula in your arm, or through a longer line such as a PICC line, port or central line.
• Tablets/capsules: These can be taken at home or in the clinic, with regular check-ups to assess how the medication is working and monitor for any side effects.
• Injections: Directly into a vein.

Specialised methods

• Intrathecal chemotherapy: This is a method of delivering chemotherapy directly into the cerebrospinal fluid (CSF) that surrounds the brain and spinal cord. It’s used to treat cancers including leukaemia, lymphoma and some brain tumours.
• During surgery: Chemotherapy can also be delivered during surgery. One example is HIPEC (Hyperthermic Intraperitoneal Chemotherapy), where heated chemotherapy is circulated inside the abdomen during an operation to treat cancers that have spread within this area.

Chemosaturation therapy, also known as percutaneous hepatic perfusion (PHP), is a highly specialised procedure that delivers a high dose of chemotherapy directly to the liver while limiting exposure to the rest of the body. It is primarily used to treat cancers that have spread to the liver, including metastatic melanoma and certain other solid tumours.

During the procedure, the blood supply to the liver is temporarily isolated, allowing a concentrated chemotherapy solution to be delivered directly to the liver. The blood is then filtered to remove excess chemotherapy before being returned to the body, reducing the risk of systemic side effects.

Your consultant will explain whether chemosaturation therapy is suitable for your diagnosis and how it fits within your wider treatment plan.

Targeted therapies (also known as precision medicine) target specific characteristics of cancer cells which are involved in tumour growth and progression. Some of these targeted drugs might also be called immunotherapies or biological therapies.

Unlike chemotherapy, which affects both cancerous and healthy cells, targeted therapy aims to ‘target’ cancer cells more precisely, reducing damage to healthy cells and minimising side effects.

At HCA UK our experts can provide a comprehensive range of targeted therapies, including:

Monoclonal antibodies (MABs): All cells have receptors on their surface that receive signals from the body. Monoclonal antibodies are designed to attach to specific receptors that are found on cancer cells. They can block signals that tell these cells to grow, and they can also help the immune system recognise and destroy them. Some monoclonal antibodies can carry drugs directly to cancer cells. There are many different types used in treatment, and the one recommended will depend on an individual’s diagnosis.

• Cancer growth blockers: Also known as cancer growth inhibitors, they block a chemical signal in the body that tells cancer cells how to develop and divide. When this signal is blocked these cells find it difficult to grow and divide, which can slow down the growth of cancer. There are many different cancer growth inhibitors used to treat cancer, the type recommended to you will depend on your individual diagnosis.

Anti-angiogenics: Anti-angiogenics target the blood supply that a tumour needs to survive. They do this by blocking the chemical signals from the body that trigger cells to grow blood vessels. This, in turn, makes it difficult for a tumour to develop the blood vessels it needs to survive and grow.

PARP inhibitors: PARPs (poly-ADP ribose polymerase) are proteins that help damaged cells to repair themselves. PARP inhibitors block these proteins from working as they normally would, so that cancer cells become more damaged and are destroyed.

If your consultant and medical team recommend targeted therapy as part of your treatment plan, they’ll make sure you’re fully informed and talk to you about the therapy they recommend and why. Along with your clinical nurse specialist, they’ll be able to answer any questions you may have, so that you can make an informed decision about your treatment.

Immunotherapy is a type of cancer treatment which helps your immune system recognise and destroy cancer cells. It works by boosting or modifying your body's natural defences to recognise and attack the cancer more effectively.

Immunotherapies can be used alone or in combination with other therapies, such as chemotherapy and targeted therapy. We provide a comprehensive range of immunotherapies, which include, but are not limited to:

Adoptive cell therapy: Is a type of personalised immunotherapy. This process involves collecting your immune cells, such as T cells, modifying or activating them in the laboratory to enhance their ability to target cancer cells, and then reintroducing them into your body in larger numbers.

One example of this is Chimeric Antigen Receptor (CAR) T-cell therapy, used to treat certain types of blood cancer. CAR T-cell therapy modifies your T-cells, multiplying them in large numbers and adding receptors that recognise specific proteins on cancer cells. These receptors then bind to the cancer cells, allowing the T-cells to destroy them.

Bispecific antibodies: These work in a similar way to normal antibodies, by binding to proteins on the surface of cells. However bispecific antibodies are created in a lab and are able to bind to proteins on two types of cells, cancer cells and normal immune cells. This will allow your T-cells to come into close contact with cancer cells and destroy them.

Cancer treatment vaccines: A new and emerging type of immunotherapy, these vaccines are customised and use your own immune cells to target specific proteins in cancer cells – or a combination of immune cells and tumour cells – to activate an immune response. We are early adopters of these new breakthrough therapies, and your consultant can discuss treatment vaccines with you and whether they could be a suitable treatment option.

Checkpoint inhibitors: Some cancers produce a high level of proteins, which can block the immune system from attacking cancer cells by “turning off” our immune cells. Checkpoint inhibitors work by blocking these proteins and allowing our immune cells to recognise and attack cancer cells.

This is just an example of some of the immunotherapies available at HCA Healthcare UK. If your consultant and medical team recommend immunotherapy as part of your treatment plan, they’ll talk to you about the type of therapy you’ll receive and answer any questions you have, so that you can make an informed decision about your treatment plan.

Hormone therapy is used to treat cancers that rely on hormones to grow, such as certain breast and prostate cancers. It works either by blocking hormones from reaching cancer cells or by reducing the body’s natural hormone production. By removing these growth signals, hormone therapy can slow or stop the progression of hormone-sensitive tumours.

Hormone therapy may be given as tablets, injections or implants, depending on the specific treatment recommended. Your consultant will explain how hormone therapy fits into your overall treatment plan and whether it will be used alone or alongside surgery, radiotherapy or other systemic therapies.