Cancer is treated with surgery, radiation therapy, chemotherapy, hormone therapy or biological therapy. Patients are often treated by a team of specialists, which may include, among others, a medical oncologist (doctor trained in cancer treatment), surgeon, radiation oncologist (doctor trained in radiotherapy). The doctors may decide to use one or a combination of methods to treat the cancer. The choice of treatment depends on the type, location, stage of cancer, the patient's age and general health, and other factors.
Some patients take part in a clinical trial (research study) using new treatment methods designed to improve cancer treatment.
Surgery is the local treatment to remove the tumour. Tissue around the tumour and nearby lymph nodes may also be removed during the operation. There may be pain after surgery for the first few days but this can be controlled by medication. It is also common for patients to feel tired or weak for a while. The length of time it takes to recover varies from patient to patient.
In radiotherapy, high-energy rays are used to kill cancer cells and stop them from growing and dividing. Like surgery, radiotherapy is a local treatment; it can affect cancer cells only in the treated area. Radiotherapy is usually given on an outpatient basis, 5 days a week, for several weeks. Patients are not radioactive during or after treatment.
The most common side effects are tiredness, skin reactions such as rash or redness, and loss of appetite. Radiation therapy may also cause a temporary lowering of the white blood cell count, cells that help protect the body against infection. The side effects are usually temporary, developing gradually over the weeks of the treatment, and improving gradually after treatment is completed.
Treatment with medicines to kill cancer cells is called chemotherapy. Most of these medications are injected into a vein or a muscle. The medicines flow through the bloodstream to nearly every part of the body, damaging cells that are rapidly dividing and growing. Normal cells that are rapidly dividing and growing, such as white blood cells, will also be affected by chemotherapy. Because cancer cells are often more immature and fragile than normal cells, chemotherapy affects cancer cells more than they do normal healthy cells.
Chemotherapy is generally given in cycles: a treatment period is normally followed by a rest period, then another treatment period, and so on. Most chemotherapy can be given on an outpatient basis.
The specific medicine or combination recommended, as well as the frequency of the treatment, depend on a number of things - the kind of cancer, its location, height and weight, how quickly the healthy normal cells recover from the treatment. Anticancer medication affects all cells that grow rapidly: cancer cells, white and red blood cells, hair and cells which line the digestive tract such as the mouth and intestines. As a result, patients may experience side effects, such as nausea and vomiting, loss of appetite, mouth sores or tiredness. Medication will usually be prescribed to minimise these side effects. These side effects go away after treatment stops.
Some types of cancer, for example, breast cancer and prostate cancer, depend on hormones to grow. For this reason, doctors may recommend therapy that prevents cancer cells from getting or using the hormones they need. Sometimes, the patient has surgery to remove the organs (like the ovaries or testes) that make the hormones. Or drugs are used to stop hormone production or change the way the hormones work.
Hormone therapy may cause nausea, swelling of the limbs or weight gain through water retention. In women, there may be irregular periods and vaginal dryness. In men, there may be impotence or loss of sexual desire.
Biological therapy, also called immunotherapy, uses the body's own immune system to fight infection and disease or protect the body from some of the side effects of other forms of treatment. Monoclonal antibodies, interferon, interleukin-2, and colony-stimulating factors such as GM-CSF and G-CSF, are forms of biological therapy.
These treatments often cause temporary flu-like symptoms such as fever and chills, muscle aches and weakness, loss of appetite and diarrhoea.