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Cancer
TEST:
If your tests confirm you have cancer, more tests will probably be carried out while you're being treated, to see how the treatment is working.The number of tests you have, how long they take and how often you'll have to go to hospital will depend on the type of suspected cancer, its location and stage.You may have more than one type of test. Here are some of the main types:
Waiting to have a test or get the results is often a tense time, but there are people andorgainsations who can support you, even before diagnosis.
This usually aims to remove as much as possible of the cancer growth, ideally all of it. You'll probably want to discuss the procedure with your doctor. Sometimes surgery is carried out to treat the complications of cancer, rather than remove the tumour itself. For example, when a tumour is pressing on a vital organ or nerve, or blocking a tube such as the intestines, an operation can help to relieve symptoms. Occasionally, during an operation to remove cancer, the surgeons find (once they are able to see inside the body) that the tumour has spread so far that surgery would not be successful and they simply close the wound up again without doing any more. Some hospitals have specialist nurses who can talk to you about the operations and their effects.
Chemotherapy is a treatment that uses strong drugs to destroy cancer cells. The drugs are often given by injection or drip. This treatment sometimes involves a stay in hospital.New drugs are continually being developed, increasingly targeted at the type of cells causing cancer in that individual patient. So, for example, women with breast cancer will be tested to check what is known as their “receptor status”. This means finding out whether the cancerous cells carry structures on their surface that make them receptive to the effects of different female sex hormones. For example, cells that are receptive to oestrogen (known as oestrogen-receptor positive) can then be treated with anti-cancer drugs that block the effects of oestrogen. If the cells carry a receptor known as her2neu (a growth-stimulating protein), they will be sensitive to the effects of a new cancer treatment called Herceptin. This is not a chemotherapy drug, although it is often given at the same time.Chemotherapy can have side-effects because the drugs cause damage to healthy cells as well as cancerous ones. These can include hair loss, tiredness, nausea, vomiting and a lowering of immunity. People's sex lives can also be affected. There are medicines that can help reduce some of these unwanted effects.
First published in February 1999.
If your tests confirm you have cancer, more tests will probably be carried out while you're being treated, to see how the treatment is working.The number of tests you have, how long they take and how often you'll have to go to hospital will depend on the type of suspected cancer, its location and stage.You may have more than one type of test. Here are some of the main types:- biopsy - examination of a piece of tissue removed from the part of the body where cancer is suspected
- blood tests
- x-rays
- scans - such as CT scans, bone scans, isotope scans, MRI scans, ultrasound scans and mammograms
Waiting to have a test or get the results is often a tense time, but there are people andorgainsations who can support you, even before diagnosis.
Diagnosis
A diagnosis of cancer means the disease has been found in your body. It takes into account your symptoms, medical history and the results of your tests. The doctor who's been supervising your tests should explain to you the type of cancer that's been found and where it is. Then, with your hospital doctor, you can plan your treatment and what you can do to help yourself.This can be a frightening time. It may be hard to take everything in at once, so ask your doctors and nurses any questions you have and don't be afraid to repeat them if you forget or don't understand what's been said.Treatment
Treatment usually begins soon after diagnosis. You can discuss all the options with your doctors and nurses. They should take your wishes into account. Not all local hospitals can treat every type of cancer, and you may be referred to a specialist cancer centre. Wherever you're treated, you should receive help from a team of health professionals who'll coordinate your care at hospital and home. If you're working - or at school or college - you may need to take time off for treatment and recovery.It can take a while to get over the effects of treatment, so it's important to eat properly and get plenty of rest to help your recovery. People can feel low or worried, but remember that you can still talk to your doctors or call staff on the ward or department where you received treatment. It may also be useful to talk to a counsellor or a member of a cancer support group.Clinical trials
Your doctor may ask whether you're willing to take part in a clinical trial. These are research studies involving patients that compare a new or different type of medical care with the best treatments currently available. If your doctor does ask you, they should explain everything it involves. It's up to you whether you take part or not. If you do, you'll be asked to sign a consent form.Further treatment
Sometimes the original (primary) cancer returns or a new area of growth that has spread from the original (secondary cancer) is found. This is called a recurrence. It doesn't mean the cancer can't be treated successfully. Your doctor will probably recommend another course of therapy or surgery.If, however, you're told further treatment won't help, it doesn't mean that nothing more can be done for you. While a cure may not be possible, there'll almost certainly be treatment options available to control the symptoms.Planning your treatment
The main types of treatment are surgery, radiotherapy and chemotherapy. For some cancers, combinations of all three may be used. Sometimes no treatment is most appropriate. Your doctor may advise you to wait and see what happens (this is sometimes referred to as 'watchful waiting'). You may want to ask your doctor why she is recommending this approach.As you plan your treatment, your specialist (the doctor coordinating your tests and treatment) will consider your general health as well as the stage of the disease (known as 'staging'). Knowing the stage of the disease will help provide an idea of how it will develop and what treatment, if any, is most appropriate. If surgery, radiotherapy or chemotherapy is recommended, you'll be asked to sign a consent form agreeing to this treatment. Do ask your doctors and nurses questions about this, and only sign the form if you're satisfied you have answers to everything you want to know. If the effects of the treatment worry or upset you, it's important to tell the staff who are treating you. They may be able to do something to help.Surgery
This usually aims to remove as much as possible of the cancer growth, ideally all of it. You'll probably want to discuss the procedure with your doctor. Sometimes surgery is carried out to treat the complications of cancer, rather than remove the tumour itself. For example, when a tumour is pressing on a vital organ or nerve, or blocking a tube such as the intestines, an operation can help to relieve symptoms. Occasionally, during an operation to remove cancer, the surgeons find (once they are able to see inside the body) that the tumour has spread so far that surgery would not be successful and they simply close the wound up again without doing any more. Some hospitals have specialist nurses who can talk to you about the operations and their effects.Radiotherapy
Radiotherapy uses high energy rays to destroy cancer cells. Treatment can be given either from outside the body or from within, by placing a radioactive material close to the tumour. Receiving radiotherapy doesn't usually involve staying in hospital, but a series of visits instead. The treatment is painless, but there can be side-effects. Some people feel tired and low, very nauseous or get swellings, and many get a skin reaction similar to sunburn in the area being treated. Most side-effects should disappear soon after treatment has ended but, very rarely, they can be severe and long term.Chemotherapy
Chemotherapy is a treatment that uses strong drugs to destroy cancer cells. The drugs are often given by injection or drip. This treatment sometimes involves a stay in hospital.New drugs are continually being developed, increasingly targeted at the type of cells causing cancer in that individual patient. So, for example, women with breast cancer will be tested to check what is known as their “receptor status”. This means finding out whether the cancerous cells carry structures on their surface that make them receptive to the effects of different female sex hormones. For example, cells that are receptive to oestrogen (known as oestrogen-receptor positive) can then be treated with anti-cancer drugs that block the effects of oestrogen. If the cells carry a receptor known as her2neu (a growth-stimulating protein), they will be sensitive to the effects of a new cancer treatment called Herceptin. This is not a chemotherapy drug, although it is often given at the same time.Chemotherapy can have side-effects because the drugs cause damage to healthy cells as well as cancerous ones. These can include hair loss, tiredness, nausea, vomiting and a lowering of immunity. People's sex lives can also be affected. There are medicines that can help reduce some of these unwanted effects.Other treatments
Other forms of treatment include hormone therapy, bone marrow transplants and peripheral blood stem transplants -. There are several specialised treatments for particular types of cancers, and new treatments are continually being researched. Your doctors and cancer organisations will be able to provide you with more details.Complementary approaches
Practitioners of complementary care usually take a holistic approach and try to support cancer patients through their treatment and after. Some people find complementary therapies help reduce the side-effects of conventional treatments as well as helping to reduce stress.Although some complementary approaches are available through the NHS and many doctors think they can be useful, they're not always accepted by the medical establishment. This is partly because, until recently, they haven't been subject to the strict medical trials by which doctors prove a treatment works. On the other hand, many people who've had cancer say they've felt benefits.If you decide on complementary therapy, it's important to tell your doctor, who'll probably be supportive of your decision. If not, you could ask if they have valid medical reasons against your choice.Some people decide to have complementary care instead of, rather than alongside, conventional medical care. Unless your doctor feels conventional treatment is no longer appropriate, they will probably not be enthusiastic about your choice. Before taking this course of action, it's important to discuss it carefully with those close to you, your doctors, complementary practitioners and cancer support groups. This article was last medically reviewed by Dr Trisha Macnair in September 2006.First published in February 1999.
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