Many things have changed in regard to the treatment of cancer in the 12 years Knoxville has done more than its share to battle the disease. Oncologist for Knoxville Hospital and Clinics, Dr. Amy Hughes, recently took the time to fill us in on the status of cancer treatment.

KHC’s oncology program started in October 2018. Last year, there were 450 patient visits for oncology – a number that continues to increase.

Hughes began her career as an oncologist in 2012. One of the biggest changes she has seen in cancer treatment is the development of immunotherapy. This therapy harnesses the power of the body’s immune system, in which the body is trained to recognize cancer cells and go after them. Another popular therapy today is Carti Radiation Therapy. This is another way to specifically attack affected cells while causing less damage to healthy tissue.

“It’s more of a streamlined, direct approach,” Hughes said. “It’s super complicated.”

What doctors have discovered through numerous trials is that side effects can vary based upon the patient. Not everyone responds to the same therapies in the same way.

“As all of the new research has come down the pipeline, they’ve realized that everyone is different biologically,” Hughes said. Often, treatment is targeted to the individual with the treatments they respond best to, being utilized.

Hughes spent two years studying the integration of natural supplements with modern medicine to treat cancer. She has no opposition to a patient using natural treatments along with the hospital’s therapy, but she needs to know if you are.

“There are interactions that can happen between natural remedies and some of our therapies,” Hughes said. “I would not personally recommend alternative therapy only.” One of the reasons for this is that modern medical treatments have undergone rigorous testing before being implemented. She also cautions that, just because something is “natural” it does not necessarily mean that it is good.

“We have no huge randomized trials like we do with pharmaceuticals,” Hughes said. There are those natural remedies that can be helpful for patients in dealing with the side effects of cancer treatment.

Tailoring cancer treatment to the individual and targeting specific cells has treatment more bearable. As Hughes puts it, “Nobody wants to give chemotherapy just to prolong suffering.”

Today’s cancer patients have a higher survival rate than years ago. Before, patients in treatment may have only months, but today years are more likely to be added to their lives – while feeling better during treatment.

More senior patients are being treated today than in the past. For most oncologists, they look at one’s physical condition without immediately thinking of age when choosing the best treatment.

“I think we’re much more focused on the actual physical activity level of the patient,” Hughes said.

There is also the mental health factors of depression, anxiety and stress when receiving a cancer diagnosis. Hughes is always upfront with her patients about the best way to handle these issues. These practices include massage therapy, yoga and a lot of extra programming for patients.

“I think patients love it,” Hughes said. “It’s a different population of patients.”
Prevention of cancer is not here yet, though we are drawing closer. There are tests that exist that can indicate one’s risk for certain cancers. The best way for everyone to avoid cancer is with clean living and healthy habits.

“I think maintenance health is very important,” Hughes said. This means getting an annual physical, taking screens recommended by primary care doctors, etc. Hughes believes the primary care physicians at KHC have done a great job and make her job easier.

One of the challenges with providing recommendations to patients is that no one in the cancer field agrees on everything. According to Hughes, there are seven reputable bodies that research and make these recommendations, but they differ.

“There is no specific consensus, which is frustrating,” Hughes said. However, oncologists recommend cancer screens begin at 40. The researchers typically say 50.

As with most other diseases, obesity can increase the risks of cancer. This is especially the case in post-menopausal women, who are most susceptible to developing cancer if they have extra weight.

“We have pretty direct evidence in regards to that,” Hughes said. Obesity often ties back to eating well to reduce your risks for cancer. Avoid processed/refined foods, soda pop, and even alcohol. In the past, doctors recommended a glass of red wine to maintain health, but now there is research to show that any alcohol can be counterproductive.

Changing one’s diet to be more plant-based and more nutritional can be difficult. Hughes recognizes that some can drop bad habits at once, but that is not the case for most people. She recommends gradually making changes in your diet so that you have a next step. You’re more likely to stick to it that way. KHC and other providers have dieticians and nutritionists available to help you down that path.

The first step, when changing your diet, is to log what you eat. This is always Hughes’s initial recommendation. Once you track your food, you may be surprised by how unhealthy your eating habits may be.

“It’s very easy to think that you’re doing okay, but when you look at what you’re actually taking in…it can be pretty eye-opening for patients,” Hughes said.

Heredity will outweigh healthy living. If one has a genetic predisposition that makes him/her more inclined to develop cancer, it cannot be completely offset by these other methods.

One of the challenges Hughes faces is that most patients today are Internet-savvy. She spends a lot more time with patients answering questions and explaining what data is good vs. bad. While she appreciates the fact her patients want to independently research their condition, it does make her job more difficult.

“There is a portion of teaching patients of where do you go to find the best sites,” Hughes said.

The goal of any treatment is to “cure” the affliction. Hughes and her colleagues are always careful with how they tell patients they no longer require treatment. No one is certain if cancer ever truly goes away.

“A lot of times, you will never hear the term ‘cure’ per se,” Hughes said. Usually, they use the term “remission” because there are patients who have been years out but then have a recurrence. Doctors do not want to give patients any false hope because the potential for recurrence never goes away. They want to do as much as possible to minimize those chances.

“There’s still a lot of investigation going on,” Hughes said. “We don’t know yet (if it truly disappears).”

Knoxville has seen many different types of cancer, with lung and breast being the most prevalent. Cancer can also occur in the bloodstream. It is no more difficult to test for blood cancers versus tumors; the tests just differ.

Most patients appreciate KHC’s new chemo room, which saves them time and money by staying in town. Hughes’s time coming to KHC will end in February, with Dr. Melina coming back.

As for the American Cancer Society, beneficiary of all of Knoxville’s Coaches vs. Cancer events, Hughes calls them a great partner that provides much needed advocacy and education surrounding the disease.

“I think they’re a pretty wonderful organization,” Hughes said.