Know Your Options
There are several categories of cancer therapies, and each category presents a range of treatment choices for the patient and the treating physician. Keeping track of the names of these treatments, as well as the categories and sub-categories they fall under, is not an easy feat. However, it helps to have a basic understanding of the various types of cancer therapies, as this knowledge can help guide your conversation with your doctor about which treatment path may be right for you.
For patients with solid tumors, surgery involves the removal of the tumor and surrounding tissue by means of an operation. Surgery is the oldest type of cancer therapy and remains an effective treatment for many types of cancer. While surgery is usually performed in a hospital or surgical center, in many cases a surgical procedure can be performed in a doctor’s office. Where you have your operation will depend on the extent of the surgery (based on the size of the tumor and how much surrounding tissue needs to be removed) and how much time you will need for recovery. Your procedure may require you to stay in the hospital overnight or longer, or you may be able to go home the same day.
Radiation is a type of therapy that uses high-energy particles or waves, such as x-rays, gamma rays, electron beams, or protons, to damage or destroy cancer cells. In cancer care, there are two main types of radiation therapy: external beam and internal radiation.
External beam radiation uses a large, sometimes noisy, machine that aims radiation at the cancer located in a specific part of your body. The machine does not touch you, but can move around you to send radiation from many different directions. In this way, the radiation is aimed where it is needed, while avoiding parts of the body not affected by your cancer. For example, if you have cancer in your lung, only your chest will receive radiation treatment.
Internal radiation therapy can be administered through a solid or a liquid that is placed inside your body. When administered in solid form, internal radiation is called brachytherapy, and involves the placement of seeds, ribbons, or capsules in or near the cancer. Liquid sources of internal radiation are given through an intravenous (IV) line, allowing the radiation to travel throughout your body, seeking out and killing cancer cells.
Either type of radiation can be given alone or with each other, or in combination with other treatments such as surgery or chemotherapy.
Chemotherapy is a type of treatment that uses drugs to kill cancer cells or to stop cancerous cells from growing or spreading in the body. As opposed to surgery or radiation therapy, which target cancer in a specific part of the body, chemotherapy works throughout the whole body. Chemotherapeutic drugs are very powerful and can sometimes damage healthy cells. While there are methods for administering chemotherapy, it is most commonly given in one of two ways: intravenously (through injections) or orally (by mouth). Chemotherapy is administered in a medical setting such as a doctor’s office, an outpatient clinic or a hospital, and is generally given in cycles. For example, you may get a dose of chemotherapy once a week for two weeks and then take the third week off, after which you may resume the two-weeks-on, one-week-off schedule in Week 4.
While the drugs used in targeted therapy are technically a type of “chemotherapy,” targeted therapy differs from traditional chemotherapy in the way it combats cancer. As the name implies, targeted therapy makes use of drugs that target specific molecules that constitute the inner workings of cancer cells. Those molecules are what makes cancer cells behave differently than normal, healthy cells. By specifically attacking the cancer cells, targeted therapy helps stop cancer from growing and spreading, while also avoiding damage to the surrounding healthy cells. As a result, targeted therapies tend to have different and less severe side effects than traditional chemotherapy.
Immunotherapy is a type of treatment that uses parts of your immune system to help fight cancer. Immunotherapy can work in a number of different ways, such as boosting the body’s natural ability to fight disease, or by training the immune system to attack cancer cells. Some types of immunotherapy involve the administration of man-made immune system proteins to stimulate your immune system. As with all treatments for cancer, immunotherapy works better for some cancers than for others. It can be used by itself or in combination with other forms of therapy.
Hormone therapy is a type of systemic therapy, meaning that it circulates throughout the body, instead of focusing on a specific area of the body. The aim of hormone therapy is to slow or stop the growth of cancer cells by adding, blocking, or removing specific hormones from the body. Hormone therapy most commonly involves taking medications that prevent cancer cells from absorbing the hormones they need to grow. It is often used in combination with other anti-cancer therapies.
Clinical trials are medical research studies that test methods of prevention, screening, diagnosis, or treatment of disease, and are a critical component of cancer research. Patients can volunteer to participate in clinical trials at any stage of disease. Some patients with cancer may fear that enrolling in a clinical trial means they have a chance of receiving a placebo (sugar pill) instead of the new treatment that is being tested. In reality, patients in cancer clinical trials receive either the best treatment currently known for their particular type of cancer, or a new and possibly more effective therapy. As with all forms of cancer treatment, you should talk to your doctor if you are thinking of enrolling in a clinical trial.
Know Your Medical Team
Your medical team consists of several different healthcare professionals that play an important role in helping you manage your cancer. From nurses to surgeons, these professionals work together to ensure you receive high-quality, comprehensive care.
As a person living with cancer, you can empower yourself by getting to know each member of your medical team, and by understanding the role each person plays in designing and managing your treatment plan. The healthcare professionals described below represent some of the more common disciplines involved in cancer care, though these are not necessarily all of the different members of your medical team. Indeed, you may encounter other specialized doctors throughout your journey.
A medical oncologist is the cancer specialist you will probably see most often. Your oncologist will oversee your general care and coordinate treatments with other specialists. Your oncologist is usually in charge of chemotherapy, hormone therapy, and immunotherapy. You will probably also visit your medical oncologist for long-term, regular checkups.
A radiation oncologist is a cancer specialist that treats cancer with radiation therapy.
Specializing in surgery, a surgical oncologist may be called in to diagnose cancer with a biopsy or to treat cancer by physically removing tumors and cancerous tissue.
A gynecologic oncologist focuses on the care and treatment of women with gynecologic cancers (cancers of the female reproductive tract), such as uterine, ovarian, or cervical cancer.
A hematologist-oncologist is a professional that specializes in the diagnosis and treatment of cancers of the blood or blood-forming tissue, including leukemia, lymphoma, and myeloma.
A pathologist is a doctor who specializes in diagnosing and classifying diseases by conducting laboratory tests and by looking at tissue and cells under a microscope. The pathologist determines whether or not your tumor is cancerous. If it is cancerous, the pathologist may also identify the exact cancer type (i.e. the body part where it started) as well as its grade (i.e. how fast it is predicted to grow).
Oncology clinical nurse specialist (CNS)
An oncology CNS is a nurse that specializes in the care of patients with cancer. These nurses can have many different roles depending on the setting. They may provide direct care, which includes administering treatment to patients, monitoring patients’ physical conditions, and managing treatment side effects. Oncology clinical nurse specialists may also conduct research related to your particular type of cancer, or teach you and your caregivers about your treatments and managing side effects.
Palliative care specialist
Palliation is a term that refers to the relief of symptoms and suffering caused by cancer and other life-threatening diseases. Palliative care is therefore designed to help patients feel more comfortable and improve their quality of life, though it does not cure the disease. There are several types of palliative care specialists, including doctors, nurses, and pharmacists, who help manage symptoms such as pain, nausea, or fatigue, and who work to keep patients as comfortable as possible.
Oncology social worker
Oncology social workers are experts in coordinating care and attending to the social and emotional needs of you and your family throughout your journey. Their duties may include counseling, helping you manage your financial affairs, assisting with housing or childcare issues (such as when you need to travel to receive treatment), or helping you cope with emotional distress.