cancer treatments
Choice of cancer treatment is influenced by the specific characteristics of the cancer, overall condition; and whether the goal of treatment is to cure the cancer, keep it from spreading, or to relieve the symptoms caused by cancer. Depending on these factors, the doctor may recommend one or more of the following:
- Surgery
- Chemotherapy
- Radiation Therapy
- Hormonal Therapy
- Targeted Therapy
- Biological Therapy
- Personalized Cancer Care
Surgery is used to diagnose cancer, determine its stage, and to treat cancer. A biopsy is a common type of surgery that may be used to help with diagnosing cancer. A biopsy involves taking a tissue sample from the suspected cancer for examination by a specialist in a laboratory. A biopsy is often performed in the physician’s office or in an outpatient surgery center. A positive biopsy indicates the presence of cancer; a negative biopsy may indicate that no cancer is present in the sample.
The side effects of surgery depend mainly on the size and location of the tumor, and the type of operation. It takes time to heal after surgery. The time needed to recover is different for each type of surgery. It is also different for each person. It is common to feel tired or weak for a while.
Most people are uncomfortable for the first few days after surgery. However, medicine can help control the pain. Before surgery, you should discuss the plan for pain relief with the doctor or nurse. The doctor can adjust the plan if you need more pain relief.
Some people worry that having surgery (or even a biopsy) for cancer will spread the disease. This seldom happens. Surgeons use special methods and take many steps to prevent cancer cells from spreading. For example, if they must remove tissue from more than one area, they use different tools for each one. This approach helps reduce the chance that cancer cells will spread to healthy tissue.
Similarly, some people worry that exposing cancer to air during surgery will cause the disease to spread. This is not true. Air does not make cancer spread.
Chemotherapy is the use of drugs that kill cancer cells. Most patients receive chemotherapy by mouth or through a vein. Either way, the drugs enter the bloodstream and can affect cancer cells all over the body.
Chemotherapy is usually given in cycles. People receive treatment for one or more days. Then they have a recovery period of several days or weeks before the next treatment session. This rest period gives the body a chance to build healthy new cells.
Most people have their treatment in an outpatient part of the hospital, at the doctor's office, or at home. Some may need to stay in the hospital during chemotherapy.
Side effects depend mainly on the specific drugs and the dose. The drugs affect cancer cells and other cells that divide rapidly:
- Blood cells: When drugs damage healthy blood cells, you are more likely to get infections, to bruise or bleed easily, and to feel very weak and tired.
- Cells in hair roots: Chemotherapy can cause hair loss. Your hair will grow back, but it may be somewhat different in color and texture.
- Cells that line the digestive tract: Chemotherapy can cause poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores.
Some drugs can affect fertility. Women may be unable to become pregnant, and men may not be able to father a child.
Although the side effects of chemotherapy can be distressing, most of them are temporary. Your doctor can usually treat or control them.
Chemotherapy can be given in these forms:
- An IV (intravenously)
- A shot (injection) into a muscle or other part of your body
- A pill or a liquid that you swallow
- A cream that is rubbed on your skin
To learn more, watch our online video “Chemotherapy and You” in our Patient Education and Videos section.
Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. Doctors use several types of radiation therapy. Some people receive a combination of treatments:
- External radiation: The radiation comes from a large machine outside the body. Most people go to a hospital or clinic for treatment 5 days a week for several weeks.
- Internal radiation (implant radiation or brachytherapy): The radiation comes from radioactive material placed in seeds, needles, or thin plastic tubes that are put in or near the tissue. The patient usually stays in the hospital. The implants generally remain in place for several days.
- Systemic radiation: The radiation comes from liquid or capsules containing radioactive material that travels throughout the body. The patient swallows the liquid or capsules or receives an injection. This type of radiation therapy can be used to treat cancer or control pain from cancer that has spread to the bone. Only a few types of cancer are currently treated in this way.
The side effects of radiation therapy depend mainly on the dose and type of radiation you receive and the part of your body that is treated. For example, radiation to your abdomen can cause nausea, vomiting, and diarrhea. Your skin in the treated area may become red, dry, and tender. You also may lose your hair in the treated area.
You may become very tired during radiation therapy, especially in the later weeks of treatment. Resting is important, but doctors usually advise patients to try to stay as active as they can.
Fortunately, most side effects go away in time. In the meantime, there are ways to reduce discomfort. If you have a side effect that is especially severe, the doctor may suggest a break in your treatment.
Some cancers need hormones to grow. Hormone therapy keeps cancer cells from getting or using the hormones they need. It is systemic therapy.
Hormone therapy uses drugs or surgery:
- Drugs: The doctor gives medicine that stops the production of certain hormones or prevents the hormones from working.
- Surgery: The surgeon removes organs (such as the ovaries or testicles) that make hormones.
The side effects of hormone therapy depend on the type of therapy. They include weight gain, hot flashes, nausea, and changes in fertility. In women, hormone therapy may make menstrual periods stop or become irregular and may cause vaginal dryness. In men, hormone therapy may cause impotence, loss of sexual desire, and breast growth or tenderness.
A targeted therapy is one that is designed to treat only the cancer cells and minimize damage to normal, healthy cells. Cancer treatments that “target” cancer cells may offer the advantage of reduced treatment-related side effects and improved outcomes.
Biological therapy is another type of systemic therapy. It helps the immune system (the body's natural defense system) fight cancer. For example, certain patients with bladder cancer receive BCG solution after surgery. The doctor uses a catheter to put the solution in the bladder. The solution contains live, weakened bacteria that stimulate the immune system to kill cancer cells. BCG can cause side effects. It can irritate the bladder. Some people may have nausea, a low-grade fever, or chills.
Most other types of biological therapy are given through a vein. The biological therapy travels through the bloodstream. Some people get a rash where the therapy is injected. Some have flu-like symptoms such as fever, chills, headache, muscle aches, fatigue, weakness, and nausea. Biological therapy also can cause more serious side effects, such as changes in blood pressure and breathing problems. Biological therapy is usually given at the doctor's office, clinic, or hospital.
Even among patients with the same type of cancer, the behavior of the cancer and its response to treatment can vary widely. By exploring the reasons for this variation, researchers have begun to pave the way for more personalized cancer treatment.
Personalized cancer care’s vision for the future will allow cancerous tissue samples to be collected carefully, diagnosed by both conventional pathology and genomic profiling, and evaluated in the context of a patient's genetic background and medical history. Based on this information, a patient will be treated with therapies or approaches that target the cancer preferentially, while sparing normal tissue.
