Cancer Treatment Options
Sometimes two different types of treatment may be equally effective in treating your cancer, but have different side effects and so will have different effects on your day-to-day life.
Doctors and other healthcare professionals can give you detailed advice about the individual treatments and how each will affect you. However, the final decision on which treatment to have, or whether to have treatment, should be yours.
It can be very helpful to find out as much as possible about the type of cancer you have and the treatments which are planned. You can then work closely with your doctors and be involved in choosing the treatment that best suits your situation.
Understanding your illness, the treatment and its side effects will help you make decisions.
The following steps may help you decide:
- Find out about the cancer.
- Take the time to consider options.
- Weigh up the advantages and disadvantages of each treatment.
- Consider how important each side effect is to you, particularly those that affect your lifestyle.
- If only one type of clinical treatment is recommended, ask your doctor why others haven't been offered.
- You may want to talk about your treatment options with your partner, family or friends.
- You may want a second opinion. Your doctor will be happy to discuss this with you.
Talking with doctors
When your doctor first tells you that you have cancer, it is very stressful and you may not remember much. You may want to see the doctor a few times before deciding on treatment.
The following tips may help you:
- Ask your doctor for a simple explanation of words you don't understand.
- Before an appointment, write down your questions.
- Take notes or record the discussion. Tell your doctor you plan to do this.
- Take a family member or friend with you to discuss the issues, take notes, or simply listen.
You can discuss the benefits and possible risks of each treatment with the health professionals looking after you. It is important to remember that it can be very difficult to predict how treatment will affect a person. This is because the same treatment can affect people differently.
Questions you may want to ask your doctor
Here is a list of questions you may want to ask your doctor:
- What treatments are available for my type of cancer?
- How effective is the treatment likely to be?
- How will my treatment affect my physical ability to do my job?
- Can I drive?
- Can I climb ladders?
- Can I work shifts?
- Can I travel by plane?
- Are there any treatment options that will make it easier for me to work?
- What are the benefits and disadvantages of the treatment?
- How long will each treatment take and what does it involve?
- Will I have to be admitted to hospital?
- What are the possible side effects of treatment?
- How can I best manage the side effects of the treatment?
- How much is the treatment likely to affect my day-to-day life?
- Will I be able to work whilst I am having treatment?
- Should/will I have to change my diet?
- What will happen if I don't want any treatment?
Once you have the answers to these questions, you may need time to think through your choices, and discuss them with your family or friends.
If you find it difficult to decide between the treatment options, it may help to talk to people who have already had those treatments. Your doctor may be able to put you in touch with other patients. You have the right to accept or refuse any treatment.
Many cancer organisations and support groups can also help you to find someone who has had a particular treatment e.g. the Cancer Council where there are chat rooms for patients, family and carers of people affected by cancer. Also check the resources list at the bottom of this page for other recommended sites.
It is often possible to find information about cancer and its treatment on the internet; however there is also a lot of misleading or inaccurate information. If you look for information on the internet it is important to use only high-quality and reputable sites.
Some people prefer to leave treatment decisions completely to their doctors, as they find this easier and less stressful. However, even if you decide to do this, it is helpful to take the time to understand what your treatment will involve and how it will affect you.
Making Decisions about Treatment
Sometimes, chemotherapy is used as the only cancer treatment. But more often, you will get chemotherapy along with surgery, radiation therapy, or biological therapy.
- Make a tumour smaller before surgery or radiation therapy. This is called neo-adjuvant chemotherapy.
- Destroy cancer cells that may remain after surgery or radiation therapy. This is called adjuvant chemotherapy.
- Help radiation therapy and biological therapy work better.
- Destroy cancer cells that have come back (recurrent cancer) or spread to other parts of your body (metastatic cancer).
How does my doctor decide which chemotherapy drugs to use?
This choice depends on:
- The type of cancer you have. Some types of chemotherapy drugs are used for many types of cancer. Other drugs are used for just one or two types of cancer.
- Whether you have had chemotherapy before.
- Whether you have other health problems, such as diabetes or heart disease.
Where do I go for chemotherapy?
You may receive chemotherapy during a hospital stay, at home, or in the outpatient unit on Ground East (which means you do not have to stay overnight). No matter where you go for chemotherapy, your doctor and nurse will watch for side effects and make any needed drug changes.
How often will I receive chemotherapy?
Treatment schedules for chemotherapy vary widely. How often and how long you get chemotherapy depends on:
- Your type of cancer and how advanced it is
- The goals of treatment (whether chemotherapy is used to cure your cancer, control its growth, or ease the symptoms)
- The type of chemotherapy
- How your body reacts to chemotherapy
You may receive chemotherapy in cycles. A cycle is a period of chemotherapy treatment followed by a period of rest. For instance, you might receive one week of chemotherapy followed by three weeks of rest. These four weeks make up one cycle. The rest period gives your body a chance to build new healthy cells.
Can I miss a dose of chemotherapy?
It is not good to skip a chemotherapy treatment. But sometimes your doctor or nurse may change your chemotherapy schedule.
This can be due to side effects you are having. If this happens, your doctor or nurse will explain what to do and when to start treatment again.
What are side effects?
Side effects are problems caused by cancer treatment. Some common side effects from chemotherapy are fatigue, nausea, vomiting, decreased blood cell counts, hair loss, mouth sores, and occasionally may cause changes to other organs.
What causes side effects?
Chemotherapy is designed to kill fast-growing cancer cells. But it can also affect healthy cells that grow quickly. These include cells that line your mouth and intestines, cells in your bone marrow that make blood cells, and cells that make your hair grow. Chemotherapy causes side effects when it harms
these healthy cells.
Will I get side effects from chemotherapy?
You may have a lot of side effects, some, or none at all. This depends on the type and amount of chemotherapy you get and how your body reacts. Before you start chemotherapy, talk with your doctor or nurse about which side effects to expect.
How long do side effects last?
How long side effects last depends on your health and the kind of chemotherapy you get. Most side effects go away after chemotherapy is over. But sometimes it can take months or even years for them to go away.
Sometimes, chemotherapy causes long-term side effects that do not go away. These may include damage to your heart, lungs, nerves, kidneys, or reproductive organs. Some types of chemotherapy may cause a second cancer years later. Ask your doctor or nurse about your chance of having long-term side effects.
What can be done about side effects?
Doctors and nurses have many ways to prevent or treat chemotherapy side effects and help you heal after each treatment session. Talk with your doctor or nurse about which ones to expect and what to do about them. Make sure to let your doctor or nurse know about any changes you notice—they may be signs of a side effect.
Certain cancers such as breast, prostate and endometrial cancer can be hormone-sensitive. Hormonal therapies are drugs that can stop or slow the growth of cancer cells by either changing the level of particular hormones in the body, or preventing the hormones affecting the cancer cells. Most hormonal therapies are given as tablets, but some are given as injections every few weeks or months.
Hormonal therapies can cause side effects such as weight gain, hot flushes, sweats, tiredness, and lowered sex drive. These treatments are usually given for months or years and they usually have less of an effect on your ability to work than other cancer treatments.
These are a newer group of treatments that work by targeting the growth of cancer cells. They generally have little effect on normal cell growth, so they usually have less troublesome side effects than cytotoxic drugs. Targeted therapies are generally used in combination with chemotherapy. They may be given as a drip (intravenous infusion) or as tablets.
Possible side effects include flu-like symptoms, chills, headaches, a temperature, low resistance to infection and tiredness (fatigue). Some treatments may also cause sickness and diarrhoea. Many people are able to carry on working while taking these drugs, but tiredness and other side effects may sometimes make this difficult.
Radiotherapy treats cancer by using high-energy x-rays to destroy the cancer cells while doing as little harm as possible to normal cells. Radiotherapy may be given in several different ways
- External Beam Radiotherapy (Teletherapy) - Uses ionising radiation from a external radiotherapy machine called a linear accelerator.
- Brachytherapy - Refers to radiation that is placed in direct contact with (or very close to) a tumour to deliver a concentrated dose of radiation directly to the cancer. It is commonly used in the treatment of cervical, endometrial and prostate cancers.
- Stereotactic radiotherapy
Radiotherapy treatment that aims to cure the cancer will often mean that you need to go to the hospital every weekday for several weeks.
Each treatment only takes a few minutes, but travelling to and from the hospital and waiting for the treatment may take up a large part of the day.
Some people manage to continue to work during radiotherapy treatment, but may need to reduce their hours. Other people stop working completely while they're having radiotherapy and for a few weeks afterwards.
Radiotherapy may make you feel tired. Radiotherapy is a local treatment, treating a particular part of the body so other side effects will depend on the area of the body being treated. For example women receiving radiotherapy to the pelvis for gynaecological cancer may experience cyststitis and diarrhoea because of the effect on the bladder and bowel. The side effects tend to begin a couple of days after the treatment starts and may slowly worsen as treatment goes on. The effects may continue for several weeks after the treatment has ended and then usually improve gradually. However, the tiredness can take longer to disappear and some people find it is many months before they regain their energy.
Surgery may aim to remove all, or part of a tumour. The effects of the surgery will depend on the part of the body being operated on and the extent of the surgery. Some operations for cancer may be carried out as day surgery, which may mean that you only have a short period of time required for recovery, others are much longer and may mean spending a few weeks or even months recovering.
Multi-modality treatment refers to when patients undergo more than one form of treatment for their cancer. Some cancer patients can undergo other forms of treatment, such as radiotherapy or chemotherapy either before and/or after surgery. Most cancers now show increased cure rates with this approach.
Clinical trials are medical research studies that test new treatments and /or revise current treatments to improve future health care
Each clinical trial has very specific criteria about who may participate in a particular study. These criteria are based on such factors as age, gender, the type and stage of a disease, previous treatment history, and other medical conditions. The criteria are used to identify appropriate participants and keep them safe. The criteria also help ensure that researchers will be able to answer the questions they plan to study. Patient participation in a clinical trial is voluntary and may provide more options for cancer treatment to patients. Some trials may provide patient access to treatments when no other treatment options are available. The staff at the Cancer Centre will identify any patient who could participate.
If you are unsure about joining a trial, discuss the option with your General Practitioner or ask for a second opinion from an independent specialist.
You can leave a clinical trial at any time.
Palliative care does not try to cure disease but aims to help you and your family improve your quality of life by addressing physical, practical, emotional and spiritual needs associated with your illness. It incorporates a range of services offered by medical, nursing and allied health professionals, as well as volunteers and informal carers.
Pain and symptom management specialists work with your care to manage complex symptoms resulting from your illness or treatment. Medications, surgery, radiotherapy, or chemotherapy or a combination of them may be used to manage these symptoms.
Complementary therapies can used in conjunction with conventional treatments and may be considered as supportive care. Some complementary therapies have been scientifically tested; others do not have strong evidence to support their use.
These therapies are sometimes called complementary medicine, holistic therapies, natural therapies, traditional therapies or traditional medicine. Integrative medicine is when conventional treatments are combined with evidence-based complementary therapies. Complementary therapies may:
- Help patients cope better with symptoms of cancer and side effects caused by conventional treatments
- Improve a patient's well-being throughout the different stages of treatment and recovery
- Provide comfort and relief for people having palliative care
Some therapies may interfere with cancer treatments and it is best to discuss this with your doctor to minimise the risk of any problems.