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As you start to learn about possible treatments, you will be asked to make decisions. Work with your healthcare team to understand the options and think about what is important to you. Before recommending a treatment, your doctor will consider the type and subtype of your cancer, treatments you have already had, the potential side effects of each treatment, and more.
Surgery is used to diagnose and/or treat cancer. It is the most common form of cancer treatment. It may be used alone or with other treatments. Common side effects of surgery are specific to the type of surgery done. They may include pain, fatigue, the risk of infection at the surgical site, scarring, and numbness. The pain and numbness are often temporary.
Chemotherapy involves the use of drugs to destroy cancer cells. It is a systemic (whole body) treatment. This means it can destroy cancer cells almost anywhere in your body. It may be given by IV (through a vein), in pill form (by mouth), as an injection (a shot), applied directly on the skin into the area around the tumor, or placed directly into the tumor site. Most often, chemo is given in an outpatient clinic. You will have a regular schedule of treatments for a set period of time.
Chemotherapy is most effective against fast growing cells, like cancer. But some healthy, normal cells may also be damaged by this treatment. The side effects will vary depending on the drug(s) you take, the dose of your drugs, and how often you get treatments. Common side effects include mouth sores, fatigue, hair loss, nausea, “chemo brain,” and low blood cell or platelet counts.
Hormonal (Hormone) Therapy
Hormone therapy is the use of drugs that block hormones that drive cancer growth. It is used to treat cancers that rely on hormones to grow, such as some breast and prostate cancers. You may be given other treatments at the same time as these drugs.
Common side effects include tiredness, hot flashes, weight gain, and loss of bone density.
Radiation Therapy (Radiotherapy)
Radiation therapy is the use of high-energy rays to kill or damage cancer cells. It is given before, during, or after other treatments. The goal is to damage as many cancer cells as possible without harming healthy tissue. To lessen damage, doses are very precise, and treatment is often spaced out.
Common side effects include nausea, fatigue, and skin changes, such as redness, dryness, or itching at the site of treatment. Other side effects are specific to the part of the body being treated. Side effects can last after treatment is done.
Immunotherapy uses the body’s natural defenses (the immune system) to find, attack, and kill cancer cells. The immune system’s job is to attack any cell that it sees as unhealthy or abnormal. Cancer cells can hide from these defenses or even stop an attack. Most immunotherapy is given by IV (through a vein). You may get treatment in a doctor’s office, in a clinic, or as an outpatient in a hospital. You may receive one or more drugs. Immunotherapy may be given on its own or with another treatment.
Targeted therapy aims to more precisely attack cancer cells. These drugs target changes in the genes or proteins of cancer cells that help them grow, divide, and spread. They treat the cancer cells with less harm to normal cells. There are different types of targeted therapy. You may get targeted therapy alone or in combination with other treatments, like chemotherapy or immunotherapy. Targeted therapy may be given as a pill (by mouth), as an IV (through a vein), or as an injection (shot). Ask if it is an option for you.
Common side effects include skin problems (rash, dry skin, itching), fatigue, or a flu-like reaction with fever, chills, and diarrhea.
Stem Cell Transplant
A stem cell transplant is an infusion of blood-forming cells (stem cells), not a surgery. The procedure has two parts. First, you will receive high doses of chemotherapy. This destroys blood cells. Next, stem cells are introduced into the bloodstream to replace blood cells. Bone marrow transplant is one kind of stem cell transplant. Sometimes patients serve as their own donors (autologous stem cell transplant). Other times, patient get stem cells from donors (allogeneic stem cell transplant).
Side effects are mainly due to the chemotherapy. They can include nausea, vomiting, diarrhea, mucositis (painful mouth sores), and fatigue. Doctors monitor patients closely to watch for serious side effects such as very low blood counts and hard-to-treat infections.
You may not need treatment right away. When your doctor watches your health closely but does not treat, it is called active surveillance, watchful waiting, or watch and wait. It is used when cancer is growing slowly and not causing symptoms or when the risks and side effects of treatment outweigh the potential benefits. It can be used for many years. Healthy exercise and diet habits are always helpful and may slow progression.
Be sure to ask about clinical trials. Clinical trials are research studies to test new treatments or learn how to use current treatments better. Today’s standard drugs were once in clinical trials. Tomorrow’s drugs are in them today.
In some cases, the treatments with the best chance of success may be available only through clinical trials. Trials are offered for many cancers, at many different stages. Everyone is not eligible for every trial. If you have cancer that has come back or spread, it is especially important to ask about clinical trials.
If you have symptoms or side effects, you may receive palliative care or want to ask for it. This care is not designed to treat the cancer itself. Instead, it will address possible symptoms caused by cancer or side effects from treatments such as pain. It can start at any point in a patient’s experience. The goal is to achieve comfort, manage symptoms, and improve quality of life. It can also help you with psychological, social, or spiritual concerns you may have. Palliative care can also be called symptom management, comfort care, and supportive care. It is often provided by a specialist doctor or nurse. Many hospitals offer palliative care to people while they are receiving other treatments for cancer. Palliative care is not hospice.