There are many different types of treatment currently available depending on the specific cancer to be treated. A team of specialists will decide which is best for you, taking into account all the information they have accumulated on your particular cancer.

An individuals treatment will depend on the stage (size and spread) of their cancer and any other characteristics that the doctors can determine.

Who to expect

During the course of your treatment, whatever it may entail, you will encounter a variety of specialists, each responsible for a specific aspect of your care.  The sheer number of people involved can be overwhelming, but it should be explained to you what the role of each person is. If at any time you feel confused or unsure, dont hesitate to ask. Here is a general list of the sort of specialists you may come across.

• Surgeon
• Clinical Oncologist (chemotherapy and radiotherapy specialist)
• Radiographer (x-ray specialist)
• Physiotherapist
• Specialist nurse
• Dietician
• Occupational therapist

Surgery

Surgery is a form of treatment designed to remove the tumour. This is something that you will talk to your medical team about as your treatment course is planned. The type of surgery involved will vary widely and ultimately depends on the site of the cancer to be removed.

What to expect

Surgery will involve an operation and a stay in hospital. If you have not had to stay in hospital before, this in itself can be a daunting experience, let alone the reason for your stay. Whether you will be in a ward or a private room, be prepared for noise. Hospitals are busy places.

You may wish to bring in personal items with you to make you feel more relaxed  perhaps some family photographs.

Before your operation it is likely that there will be some preparation, depending on the site of your surgery, which will entail you being in hospital. It is possible that this will involve a period of fasting immediately beforehand. Remember to consult with your medical team to make sure you understand the timescale of your operation and recovery schedule.

After the operation you may wake up to discover yourself attached to tubes and machines. Dont be alarmed  they will help your recovery. To avoid any unnecessary shocks, make sure that you have talked to your medical team before the operation so that you are fully aware of what to expect when the operation is over.

Depending on the site of the cancer, there may be changes in your body to get used to  for example, the loss of a breast. Remember that any scarring will be at its worst immediately after the operation and will take time to heal. Try to bear this in mind in the days following the surgery and give yourself a chance to recover from the sheer physical aspects of the treatment.

Chemotherapy

Chemotherapy is a form of treatment that uses drugs to kill cancer cells. The drugs work by interfering with the cancer cells ability to divide and grow. Different chemotherapy drugs act in different ways and attack the cancer cells at different phases of their growth.

What to expect

Chemotherapy drugs are usually given by injection in a vein (intravenously). Less common methods are by mouth (orally) or injection into a muscle (intramuscularly) or under the skin (subcutaneously). Whatever the method, the drugs are absorbed and circulate in the bloodstream, with the aim of destroying any cancer cells that may have spread from the original tumour to other parts of the body. 

In general, this treatment is given as a course of several sessions over several weeks, with recovery periods built into the schedule.

Chemotherapy is often given in combination with other treatments such as surgery and/or radiotherapy, to increase their effectiveness. It may also be given even when standard tests or scans have not detected any cancer spread as an additional preventative measure following surgery, to kill any stray cells. This is called an adjuvant treatment.

Many different types of chemotherapy are used depending on the individual cancer. As different systems of the body are exposed to the drugs, this is known as a systemic treatment.

Side effects

Different chemotherapeutic drugs can produce different side effects. Make sure that you have been told what kind of things you are likely to encounter with the specific drugs involved in your treatment, before your treatment starts.

The fact that cancer cells divide rapidly is a characteristic exploited by many cancer treatments. Unfortunately, these treatments often work by targeting all rapidly growing cells. In other words, they are not specifically directed to the cancer cells. In this way some healthy dividing cells in the body are damaged as a consequence. The prime areas affected are cells that are normally rapidly dividing themselves such as the mouth, digestive system, skin, hair and bone marrow. The side effects associated with chemotherapy come from unwanted additional affects on these healthy good cells.

Reducing the impact of the unwanted effects of chemotherapy and radiotherapy

It is helpful to remember that almost all of these unwanted effects are short term. Things will gradually return to normal  for instance, your hair will grow back once the treatment has stopped. However, there are many things that you can do to reduce their impact during the course of the treatment. Clearly, this will depend on the side effect experienced. Talk to your medical team about what they recommend in your particular circumstance.

Nausea

Hair loss

If this is a likely outcome of your treatment you may want to consider having your hair cut short before treatment begins. This will make the transition more gradual and also put less pressure on the hair. Other strategies include using very gentle hair products and being careful when brushing and combing your hair as it may be quite brittle.  Try to avoid using hair driers and ask about wigs at an early stage of your treatment.

Tiredness

Cancer treatments may leave you very tired. It is important to give yourself time to rest and not try and do too much. On the other hand, it is important to have some distraction. Try and set realistic expectations about what you can and cannot do depending on how you feel.

Make sure that you try and eat even if you find that you have little appetite. Good nutrition is vital. If you are not eating enough, talk to your doctor or dietician for advice.

Radiotherapy

Radiotherapy is a form of treatment that uses radiation to kill cancer cells. It works by destroying the cancer cells in a specific treated area.  It is often called a local therapy, because it affects cells only in the treated area. Although normal cells are also affected, they are able to repair themselves more effectively than cancer cells.

What to expect

The treatment is usually divided up into sessions to help the normal cells to recover. Many people have their treatment daily, with a rest at weekends; others have different treatment plans. How your treatment is arranged will depend on the location of your tumour. Because radiotherapy is precisely targeted to treat exactly the right area, there has to be careful planning to determine that the correct location is identified every time. This can take the form of skin markings or possibly a plaster cast may be made of the area in question, for example the head.

Radiotherapy is often given in combination with other treatments to increase effectiveness. It can be given to destroy the tumour, as a curative treatment  or it may be given to relieve the symptoms of disease, for example to reduce pain. This is called palliative treatment.

Side effects

Whilst the damage to normal cells is usually temporary, it is this damage that causes the unwanted side effects associated with radiotherapy. As radiotherapy is carefully targeted, the side effects will depend on the location of the tumour and could potentially include hair loss, a painful mouth, nausea and loss of appetite.

A general side effect to this treatment is tiredness.

Other treatments

Clinical trials

Your doctor may ask if you are willing to take part in a clinical trial.  This is a research study that analyses groups of patients in order to compare new or different types of medical care or treatment with the best currently available.

If you are asked to take part, your doctor should explain everything that would be involved. It will be entirely your decision whether you do take part  but if you do you will be asked to sign a form giving your consent.

03/06/2009