Today, doctors have four major types of treatment for cancer — chemotherapy, radiation therapy, surgery and hormone therapy. Your treatment plan will probably include one or more of these treatments, depending on your cancer type, the stage of your cancer, your health, your lifestyle and your personal preferences. The plan may have one of three possible goals:
• Prevent your cancer from spreading
• Relieve the symptoms caused by cancer
• Remove the cancerous tumor
Use the links below to learn more about each treatment type and download questions to ask your doctor about each option:
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Chemotherapy
Chemotherapy is a group of medicines used to treat cancer. While surgery and radiation therapy target specific areas of cancer, chemotherapy works throughout the body and can destroy cancer cells that have spread (metastasized) from the original cancer site.
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How Does Chemotherapy Work?
Chemotherapy destroys cancer cells. Some cancer cells grow slowly; others, rapidly, so different types of chemotherapy drugs are designed to target the growth patterns of different types of cancer cells. Each drug works in a specific way for specific cancer types and is most effective at a specific time in the life cycle of the targeted cells. If your treatment plan includes chemotherapy, your doctor will determine the right time to administer it based on your cancer type, its stage and your overall health.
Depending on your individual condition, your chemotherapy may be designed to achieve one or more of three goals: remission, control and/or symptom relief.
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How Do I Take Chemotherapy?
You can receive chemotherapy drugs in one or more of the following ways:
• Shot (injections using a syringe and needle)
• IV (intravenously, by dripping medicine through a tube into the vein)
• Pill (oral medication)
Your doctor will choose the method that will be most effective against your particular type of cancer and cause the fewest side effects.
Some types of chemotherapy can be taken at home. You and your family members can learn how to administer chemotherapy in pill form or by injection with small syringes and needles similar to the ones people with diabetes use for insulin.
In some cases, a nurse will give your chemotherapy in an outpatient clinic. In other situations, you may need to go to the hospital to receive treatment.
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How Often Do I Take Chemotherapy?
Chemotherapy is usually structured in cycles with rest periods in between. Generally, you receive treatments daily, weekly or monthly.
How often you take chemotherapy depends on your cancer type, cancer stage and which drug or combination of drugs you receive. Your doctor will develop a treatment schedule based on all of these factors.
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What Are Possible Side Effects?
Chemotherapy works by destroying cancer cells. Unfortunately, chemotherapy can’t distinguish between cancer cells and healthy cells; therefore, it may destroy healthy cells along with cancer cells, causing unwanted side effects. Among the most common are nausea, vomiting, hair loss, fatigue and low blood counts.
Some side effects may be temporary and easily managed with medication. Others, however, can be life-threatening. Be sure to tell your doctor about any side effects you experience. In most cases, your doctor can help you successfully manage side effects without disrupting your ongoing treatment cycles.
Learn More about Dealing with Side Effects
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How Do I Know My Chemotherapy Is Working?
Each person responds differently to treatment, so how you feel is not an accurate gauge for how well the treatment is working. Additionally, since some people experience side effects from their treatment and others don’t, the presence or absence of side effects is not a reliable way to measure your treatment’s effectiveness. Your doctor will closely monitor and measure your progress. It’s best to check with him/her about your current progress and any questions or concerns you may have regarding the effectiveness of your treatment.
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How Can I Learn More about Chemotherapy?
Your healthcare team is always your best source of information about your treatment and how to deal with possible side effects. To ensure that you get all the information you need, it’s a good idea to keep a treatment journal or notebook and take it to all of your doctor’s appointments to help you remember questions you want to ask. We’ve prepared a list of questions you can download to help you get started.
Questions to Ask Your Doctor about Chemotherapy
Note: This download and others are also available in the Patient Resources section.
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Radiation Therapy
Radiation therapy is the use of high-energy x-rays focused directly at the site of your cancer to stop the cells from growing and multiplying. About half of all people with cancer receive radiation therapy alone or in combination with other treatments, and for many individuals, radiation is the only cancer treatment they need.
There are many different types of radiation therapy as well as various ways of delivering it. You may also hear it referred to as radiotherapy, x-ray, cobalt or irradiation therapy, IMRT (intensity-modulated radiation therapy), EBRT (external beam radiation therapy), IGRT (image-guided radiation therapy), or SRS (stereotactic radiosurgery).
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What Is the Goal of Radiation Therapy?
The goal of radiation therapy depends on your specific type of cancer and your overall health. Generally, radiation therapy is designed to achieve one or more of the following results:
• Stop the growth of cancer cells to reduce their size before surgery or stop their growth after surgery.
• Improve your quality of life. Even if it’s not possible to cure certain cancer cases, radiation therapy may still improve symptoms and provide relief from pain and discomfort.
• Reduce the possibility of metastases, or disease spreading to other locations or organs within the body.
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How Do I Get Radiation Therapy?
Radiation therapy is given in doses measured in grays or centigrays for several weeks. Radiation may be delivered either externally or internally.
External radiation is the most commonly used type. In external radiation, high-energy X-rays are directed at the cancer cells from the outside of your body.
Internal radiation, also called brachytherapy, is delivered from within your body in the form of precise amounts of radioactive material in an implanted device such as a catheter or other type of applicator. The radioactive material remains in place for the time required to destroy the cancer cells. That may be a short period of time or the material may be implanted permanently.
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How Do Doctors Target the Radiation Therapy?
Today’s advanced technologies combine radiation delivery with different types of imaging, which allows the radiation oncologist to see a picture of the area to be irradiated. This means that the oncologist can more precisely target tumors with the radiation. More precise targeting results in a smaller area of healthy cells exposed to the radiation, which means fewer side effects. Two examples of advanced external radiation technologies are:
• Intensity Modulated Radiation Therapy (IMRT)
• Image-Guided Radiation Therapy (IGRT)
Intensity Modulated Radiation Therapy (IMRT) is an external radiation therapy that uses an imaging technology, such as Computed Tomography (CT), to build three-dimensional images of the treatment area. The oncologist can then make a treatment plan map to deliver tightly focused radiation beams directly to the tumor without needles, tubes or catheters. Varying the intensity of the beams maximizes the amount of radiation delivered to the cancer cells while minimizing the effect on surrounding healthy cells.
Image-Guided Radiation Therapy (IGRT) is another external therapy. It uses ultrasound technology — called BAT®, or Bi-mode Acquisition and Targeting — to help locate the tumor prior to radiation therapy. BAT combines ultrasound with a 3D tracking system to pinpoint the tumor quickly and accurately, reducing the amount of healthy tissue exposed to radiation. BAT® is particularly effective on smaller or odd-shaped tumors.
High Dose Rate (HDR) brachytherapy is an advanced treatment for internal radiation. Like IMRT and IGRT, HDR allows doctors to deliver precise radiation therapy to your tumor. HRD is frequently used to treat cervical and uterine cancers and certain kinds of lung and esophageal cancers. Recently, it has also proven effective in treating early-stage prostate cancer.
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What Is a Radiation Therapy Session Like?
A radiation therapy team consists of a radiation oncologist, a radiation therapist (who delivers the radiation therapy), physicists and dosimetrists, who all work together to develop your treatment plan and dosage calculations.
Before your treatment, you will have a simulation session where your team will map out the location(s) for your radiation therapy using either a CT scanner or x-ray positioning. Small reference marks called tattoos will be marked on your skin to help your team to target your treatment on a daily basis.
Your team will make sure you understand everything that will happen before you go in for your first treatment. Generally, you won’t feel anything during treatment, and many people arrange their treatment around their work schedules or other daily commitments.
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How Can I Learn More about Radiation Therapy?
Your healthcare team is always your best source of information about your treatment and how to deal with possible side effects. To ensure that you get all the information you need, it’s a good idea to keep a journal or notepad to help you remember questions you want to ask. In addition, we’ve prepared a list of questions you can download to help you get started.
Questions to Ask Your Doctor about Radiation Therapy
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Surgery
Doctors often use surgery to diagnose cancer, determine its stage of development and treat it. In addition to helping in the diagnosis of cancer, surgery can also provide other benefits:
• Removal of the tumor — Sometimes surgery involves completely removing cancer cells. Surgery alone may be effective, or your doctor may recommend combining it with other options, such as chemotherapy and/or radiation therapy, for the best results.
• Symptom relief — Your doctor may determine that surgery can help treat possible side effects of cancer, such as pain.
• Reconstruction — When necessary, surgery can help minimize deformities caused by cancer and, as a result, improve your quality of life.
Talk with your doctor about whether surgery is right for you. If, together, you determine that it is, be sure to discuss the specific goals of your surgery, what to expect, potential side effects, and how to prepare for the surgical procedure and recovery.
What Is a Biopsy?
How Can I Learn More about Surgery?
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What Is a Biopsy?
One common type of surgery that may be used to help with cancer diagnosis is a biopsy. A biopsy involves removing a tissue sample from your body for examination by a specialist in a laboratory. A positive biopsy indicates the presence of cancer; a negative biopsy indicates that no cancer is present in the sample.
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How Can I Learn More about Surgery?
Your healthcare team is always your best source of information about your treatment and how to deal with possible side effects. To ensure that you get all the information you need, it’s a good idea to keep a journal or notepad to help you remember questions you want to ask. In addition, we’ve prepared a list of questions you can download to help you get started.
Questions to Ask Your Doctor about Surgery
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Hormone Therapy
Hormone therapy is a form of cancer treatment that uses drugs to block or reduce the amount of certain hormones known to cause cancer cells to grow. It is a systemic therapy in which drugs can be given by mouth or directly into the bloodstream. It may be used to treat women with some types of breast cancer and men with prostate cancer.
Why Is Hormone Therapy Used in Treating Breast Cancer?
Why Is Hormone Therapy Used in Treating Prostate Cancer?
How Can I Learn More about Hormone Therapy?
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Why Is Hormone Therapy Used in Treating Breast Cancer?
The hormone estrogen promotes the growth of about two out of three breast cancers in women. Estrogen is mainly produced in the ovaries. Blocking the effect of estrogen or lowering estrogen levels can be used to treat some types of this disease. Blocking or lowering estrogen may also be used as an adjunctive therapy — a secondary therapy that assists the primary treatment — following surgery or other cancer treatment.
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Why Is Hormone Therapy Used in Treating Prostate Cancer?
The hormone therapy known as androgen deprivation therapy (ADT) or androgen suppression therapy is used to reduce levels of the male hormones, called androgens, in the body. The main androgens are testosterone and dihydrotestosterone (DHT). Produced mainly in the testicles, androgens stimulate prostate cancer cell growth. Lowering androgen levels often makes prostate cancers shrink or grow more slowly and can be used in several situations:
• If you cannot have surgery or radiation or the cancer has already spread beyond the prostate gland
• If your cancer remains or comes back after tretment with surgery or radiation therapy.
• As an addition to radiation therapy for initial treatment if you are at high risk for cancer recurrence
• Before surgery or radiation to try to shrink the cancer to make other treatments more effective
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How Can I Learn More about Hormone Therapy?
Your healthcare team is always your best source of information about your treatment and how to deal with possible side effects. To ensure that you get all the information you need, it’s a good idea to keep a journal or notepad to help you remember questions you want to ask. In addition, we’ve prepared a list of questions you can download to help you get started.
Questions to Ask Your Doctor about Hormone Therapy
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