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Chemotherapy
In many treatment scenarios, your doctor will choose a chemotherapy plan designed to fight your specific cancer. This chemotherapy plan is called a regimen and outlines how much chemotherapy you'll receive and how often it is to be delivered. Don't be afraid to ask questions about why this regimen was chosen and what to expect. The more you know, the more confidence you'll build in preparation to beat the cancer.
Chemotherapy is the use of drugs to destroy cancer cells. Normal cells grow and die in a controlled way. When cancer occurs, abnormal cells keep dividing and forming more cells, without control. Chemotherapy drugs destroy cancer cells by stopping them from growing and multiplying. However, healthy cells can also be harmed, especially those that divide quickly, such as white blood cells.
Harm to healthy cells is what causes many of the side effects associated with chemotherapy. The kind of side effects you may experience depends on the type of chemotherapy drugs you are taking, the dosages, and the frequency of treatments.
The type of chemotherapy given depends on the type of cancer you have, the stage of your cancer, and your overall health. More than half of the people diagnosed with cancer get chemotherapy. There are many different types of "chemo" drugs available; generally you and your oncologist will discuss a specific protocol, or treatment plan, considered the standard of care for the cancer you have.
"Stay the course"
One of the most critical things you need to think about with chemotherapy is that it is important to "stay the course." Unnecessary changes or delays in your chemotherapy treatment schedule can have physical and emotional consequences. It is very important that you report any symptom or side effect to your doctor and/or nurse so that it can be evaluated and treated effectively.
In one recent study1, an ongoing review of medical charts for more than 17,000 women with early-stage breast cancer receiving chemotherapy showed that:
 Up to 20% of patients were receiving less than 85% of the
planned chemotherapy dose intensity. Published data suggest
that dose intensity above 85% results in the best chances for
relapse-free and overall survival.2
28% of these women had their chemotherapy doses lowered. 44% had to have treatments re-scheduled.3 What was the most common reason? Low white blood cell counts, a circumstance that may not occur if supported proactively, can increase the risk of infection.
"This is not your grandmother's chemotherapy!"
Many of the stories you may have heard about chemotherapy treatments are no longer true. More effective drugs in higher doses and different combinations now improve the possibility of long-term survivorship. Modern advances in medications can reduce (and sometimes completely eliminate) nausea and vomiting as well as cancer pain. Other special medications, called blood cell growth factors, help your blood counts return to normal more quickly to reduce the possibility of infection and unnecessary hospitalizations.
Chemotherapy is generally administered in an outpatient clinic on a regular schedule for a specified period of time. You may receive a combination or sequence of drugs that has proven to be most effective. Chemotherapy may be given in a variety of ways:
intravenously (by vein)
in pill form (by mouth)
through an injection (shot)
applied directly on the skin.
Get all the information you can from your doctor and health care team regarding your specific treatment and what to expect in the weeks and months ahead. You may want to chart your treatment plan and follow-up appointments on a special calendar so you stay on schedule.
What can chemotherapy do?
Depending on the type of cancer and how advanced it is, chemotherapy can be used for different goals:
Cure the cancer. Cancer is considered cured when the patient
remains free of any evidence of cancer cells.
Control the cancer. Control is keeping the cancer from spreading;
slowing the cancer's growth; and killing cancer cells that may
have spread to other parts of the body from the original tumor.
Relieve symptoms that the cancer may be causing. Relieving
symptoms such as pain and discomfort can help patients live
more comfortably.
Radiation treatment
Radiation treatment is the use of high-energy rays to stop cancer cells from growing and multiplying. The therapy is usually given to the exterior of your body by a machine that can pinpoint high-energy beams directly to the location of your cancer.
Radiation treatment is also referred to as:
radiotherapy
X-ray therapy
cobalt therapy
irradiation therapy
Half of all people with cancer are treated with radiation. For many, radiation is the only kind of treatment needed. Radiation therapy is given in doses (measured in rads or grays), five days a week, for several weeks. You will work very closely with the radiation oncologist and a highly skilled group of radiation therapists who will support you with high-tech, high-quality care.
Prior to radiation you will get precise measurements of where the radiotherapy is to be given. The technicians will draw special markings on your skin to guide them and the machine in giving you effective treatment. You will not be radioactive during this time and generally won't feel anything during the treatment itself except a little discomfort due to lying still for a period of time. Many people are able to arrange their daily radiation appointments around work or other daily activities. Sometimes the best time to go is early in the morning-that way you have your whole day to be active.
Another kind of radiation treatment involves internal radiation; exact amount of radioactive material is implanted inside your body, usually in an area that involves cancer of the vagina, prostate or breast. The implant is left there for a few days. During that time you will generally stay in the hospital while the radioactive implant works to destroy the tumor.
What can radiation therapy do?
Like chemotherapy, the goal of radiotherapy depends on the type of cancer and how advanced it is. Radiotherapy can be used to:
Shrink the tumor. Radiation can be an important tool to stop the
growth of cancer cells that remain after surgery or to reduce
the size of a tumor before surgery.
Improve quality of life. Even when curing the cancer is not
possible, radiation therapy can still bring relief. Many patients
find that symptoms (such as pain) are greatly improved
with radiotherapy.
How can you prepare for chemotherapy and radiation treatment?
Patients who prepare for chemotherapy and radiation treatment say they are better able to handle the physical and emotional effects of their treatment. People who have been through chemotherapy and radiation treatment say it is very helpful to:
Talk to others who have been through the experience.
Talk with your doctor and carefully weigh the many options
presented to you.
Set goals and rewards for yourself as you reach treatment
milestones.
Pray and seek spiritual support.
Be active in gathering information and getting second opinions.
Prepare a question list and keep a journal of your visits with your
doctor.
Tape-record your conversations with your doctor and health care
team to play again for yourself or family members.
Bring someone with you to your appointments for emotional
support and to hear what is being said so you can discuss
it together later.
Talk to your oncology nurse about your questions or concerns.
Consider talking to a social worker or counselor to help you and
your family prepare for emotional and social issues.
Join a support group with others who are going through cancer
treatment.
Anticipate certain physical side effects such as fatigue, hair loss,
nausea, fever, and infection. For example, allow yourself plenty
of time to rest during your treatment.
Surgery
Surgery is used in the diagnosis, staging, and treatment of cancer. It can also be used to minimize the symptoms of advanced disease to relieve distress. And surgery is used for reconstructive and rehabilitative purposes. Surgery has played a major role in the cure of melanoma, breast, colorectal, and thyroid cancers if caught early.
Many people have a biopsy-a procedure where a tissue sample from an organ or other part of the body is extracted for examination by a pathologist-to confirm, or diagnose, cancer correctly. A positive biopsy indicates the presence of cancer; a negative biopsy may indicate that no cancer was present or that the biopsy specimen was inadequate.
What can surgery do?
Diagnose and stage the cancer. Surgery can identify the tumor
type, extent of growth, size, nodal involvement, and regional
and/or distant spread.
Cure the cancer. The primary goal of cancer surgery is cure.
Definitive or curative surgery involves removing the entire
tumor, associated lymph nodes, and a margin of
surrounding tissue. Early diagnosis is essential when the goal
is cure.
Relieve the symptoms. Surgery can be used to minimize
symptoms of advanced disease, such as neurosurgical
procedures for pain control.
Reconstruct or rehabilitate. Sometimes the goal of surgery is to
minimize deformity and improve the patient's quality of life
(as in breast, head and neck reconstruction).
Surgery alone can be curative in patients with localized disease, but it is often necessary to combine surgery with other types of treatment in order to achieve higher response rates.
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