If you’ve recently been diagnosed with cancer, you probably have many questions running through your mind. Top among these is, what’s next? The next step after diagnosis may be treatment. Treatment aims to remove the cancer cells or destroy them. Here is information on types of treatment and what you can expect during treatment.
Path to improved health
The three most common types of cancer treatment are surgery, radiotherapy, and chemotherapy.
Surgery is a way to physically remove the cancer. Surgery can be very successful in treating some kinds of cancer. But it isn’t an option in all cases. It may be possible to safely remove a tumor and any affected surrounding tissue. This can happen if:
- the cancer is in the form of a malignant tumor (a tumor that spreads), but
- the tumor is still in one place (localized).
Surgery may not be possible if:
- the cancer has spread to other areas of the body
- the tumor cannot be removed without damaging vital organs.
Different types of surgery can remove cancer. In addition to standard surgery, some of these include:
- Laser surgery. Beams of light and sometimes heat from a laser target and destroy cancer cells.
- Mohs’ surgery. Layers of cancer cells are removed one at a time. The doctor examines each layer before removing the next layer. This way, only the diseased layers are removed. Healthy tissue remains intact.
- Cryosurgery. Cancer cells are frozen and destroyed. A very cold material is used, such as liquid nitrogen.
- Laparoscopic surgery. The doctor makes very small incisions in the body. He or she inserts a tiny camera to see inside. The camera sends signals to a video screen so your doctor can see the tumor and your organs. They use a surgical tool to remove the tumor.
Radiotherapy uses radiation to damage cancer cells so that they can’t multiply. The radiation is in the form of X-rays, gamma rays, or electrons. There is usually no pain during this kind of therapy. Depending on the area being treated, radiation could damage normal tissues. This could cause side effects. Your doctor can tell you what to expect. Radiotherapy is sometimes the only treatment needed. It is also used with other therapies. A combination of surgery and radiotherapy may be used for tumors that grow in one place.
Chemotherapy uses strong medicines to attack the cancer cells. The word “chemotherapy” sometimes causes a lot of fear. The side effects can be severe. However, not all people experience severe side effects. You can often treat the side effects with other medicines.
Chemotherapy is often the best choice when the cancer has spread to other areas in the body. It can also be used with surgery and radiation. Sometimes the tumor is surgically removed. Then chemotherapy makes sure that any remaining cancer cells are killed.
Other treatments are available in some cases. These include:
- Immunotherapy (also called biological therapy). This treatment triggers the body’s immune system to produce more white blood cells. These cells are called lymphocytes. Two kinds of lymphocytes can attack and kill cancer cells: T-cells and B-cells. Immunotherapy helps boost the ability of these cells to kill cancer. This therapy can be used with surgery, radiation, or chemotherapy.
- Hormone therapy. This is sometimes used to treat breast or prostate cancer. These cancers are fueled by hormones. Natural hormones estrogen or testosterone can cause cancer cells to grow. So other hormones are given to you. These other hormones block the effects of the estrogen and testosterone. In other cases, you may have surgery to remove the ovaries or the testicles. Removing these organs reduces the amount of estrogen or testosterone in the body.
- Targeted drug therapy. Some cancer cells contain abnormalities that allow them to survive and grow. They may have extra proteins, or they may have hormone receptors attached. Doctors can use special therapies against these specific abnormalities to fight the cancer.
- Clinical trials. New medicines and therapies are tested on people to see if they are safe and effective. Thousands of trials are going on at any one time. Talk to your doctor if you are interested in participating in one. He or she can discuss the benefits and risks with you.
Other specialized treatments may be available.
Some people may choose not to pursue treatment. They may decide to focus on palliative care. This type of care focuses on providing relief from symptoms and stress of the cancer. Your doctor may talk to you about treatment and which options are best for you.
How do I decide what treatment option to use?
Your doctor, or a team of doctors, will help you understand your options. They will recommend options for treatment. Many factors are involved, including:
- the stage your cancer is in
- what organs are affected
- the type of cancer you have
- your age and health
- the potential side effects of treatment.
You and your doctor will want to consider the advantages and disadvantages of each therapy. Your doctor may want to discuss alternative therapies in case your cancer doesn’t respond to treatment.
Who does what in my treatment program?
Cancer treatment can be very complex. Several factors affect the kinds of health care professionals you’ll see. These include the kind of cancer you have, the stage that it’s in, and your treatment program. Here are some of the specialists you may see:
Family physician — may oversee your treatment and rehabilitation programs. He or she is a good resource to help answer questions you may have.
Oncologist — may manage your treatment program. An oncologist is a doctor who treats people with cancer.
Surgeon — may operate to remove the cancerous tissue.
Pathologist — Checks for signs of cancer in the tissue removed during a biopsy or surgery.
Radiation oncologists — administer radiation treatment. Diagnostic radiologists, radiotherapy technologists and radiation physicists often help them. They plan treatment and check the radiation dosages. This ensures that treatment is as safe as possible.
Laboratory technicians or nurses — may draw your blood for tests.
Nutritionists — evaluate your diet. They help you plan your meals during and after treatment.
Physical therapists — help you keep your muscle tone. They help restore your ability to move if your body changed during treatment.
Psychologists, therapists, social workers or clergy — help you talk through your feelings. They help you manage the emotional reactions to your cancer and cancer treatment.
Pharmacists — mix your complicated medicines. They check that you are getting the correct dosages.
Talk to your doctor if you have questions or concerns about your treatment. If something is on your mind, ask about it. Be an active participant in your care.
Things to consider
Cancer treatment affects every person differently. There are often side effects to different treatment options. Some people have few side effects or even none at all. However, the side effects of cancer treatment make many people feel sick. Common side effects include:
- feeling sick/not feeling hungry
- weight loss
- weakness and fatigue
- hair loss
- mouth soreness and sensitivity
- depression or feelings of sadness, anger, or fear.
Your doctor will tell you what side effects you might experience. He or she will tell you which are unusual and when you should call the doctor’s office.
Don’t downplay your side effects. It’s important to tell the people around you how you are feeling. This includes your doctor, members of your care team, and your family. If you feel very sick, very tired, or are in a lot of pain, your doctor may be able adjust your treatment. Or they can give you other medicine to help you feel better.
Questions to ask your doctor
- How long after I’m diagnosed will treatment begin?
- What treatment will be best for me?
- How does my overall health affect what treatment I will receive?
- How long will my treatment last?
- Will I be able to work while undergoing treatment?
- What side effects can I expect with this treatment?
- What can I do to cope with these side effects?
- Is there a special diet I should eat while I’m being treated for cancer?
- Are there any alternative treatments that might work for me?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.