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Macmillan and Cancerbackup have merged. Together we provide free, high quality information for all.
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The aim of cancer treatment for many people is to cure the cancer. In some cancers that are very slow-growing, or that have spread beyond their original area of the body, the aim may be to control the cancer and delay its progress. Treatments that are most commonly used include surgery|, radiotherapy| and anti-cancer drugs (chemotherapy|, hormonal therapy| and targeted therapies). These may be given alone or in combination and are described below.
Surgery| may aim to remove all, or part of a tumour. The effects of the surgery will depend on the part of the body being operated on and the extent of the surgery. Some operations for cancer may be carried out as day surgery, which may mean that you only need to take a short time off work. Other operations are much larger and may mean spending a few weeks, or even months away from work. Some operations may mean that your ability to work is significantly affected – for example, if you have to have a limb amputated.
Radiotherapy| treats cancer by using high-energy x-rays to destroy the cancer cells while doing as little harm as possible to normal cells. Radiotherapy treatment that aims to cure the cancer will often mean that you need to go to the hospital every weekday for several weeks.
Each treatment only takes a few minutes, but travelling to and from the hospital and waiting for the treatment may take up a large part of the day.
Some people manage to continue to work during radiotherapy treatment, but may need to reduce their hours. Other people stop working completely while they’re having radiotherapy and for a few weeks afterwards.
Radiotherapy may make you feel tired|. Other side effects will depend on the area of the body being treated. The side effects tend to begin a couple of days after the treatment starts and may slowly worsen as treatment goes on. The effects may continue for several weeks after the treatment has ended and then usually improve gradually. However, thetiredness can take longer to disappear and some people find it’s many months before they regain their energy.
There are more than a hundred different drugs used in the treatment of cancer, and these fall into three main groups – cytotoxic drugs, hormonal treatments and targeted therapies:
Many of these drugs have been around for over 50 years and are what most of us think of as ‘chemotherapy’. The drugs interfere with the process of cell division, but affect normal cells as well as cancer cells. As a result, they often cause side effects.
The drugs are usually given as a liquid through a drip into a vein (intravenously), so that they can circulate in the bloodstream and reach the cancer cells wherever they are in the body. Some types are taken as tablets or capsules.
Chemotherapy| is usually given in cycles of treatment. The drug (or drugs) is given and then followed by a few weeks of rest, so that the body can recover from the effects of the treatment. Intravenous chemotherapy may take minutes, hours or a few days. Usually 4–6 cycles of treatment are given, which takes from 4–8 months. Some treatments for particular types of cancer last much longer than this, others may be shorter.
Sometimes a drug is given continuously into the vein by a small portable pump over the course of a few months. This is known as a continuous infusion. Some chemotherapy treatments are given as tablets or capsules to take at home.
Cytotoxic chemotherapy affects people in different ways. Some people find that they can’t work at all. Others find they can keep working or that they just need to take a few days off aftertheir treatment and can then work until their next treatment.
Cyotoxic chemotherapy can cause unpleasant side effects. It can temporarily stop the bone marrow from making new blood cells. This means your immunity is reduced and you’re more prone to infections|. You may also become anaemic (when the number of red blood cells in your blood is low) or have bleeding problems, such as nose bleeds or bruise easily.
If the bone marrow is not working properly you may need to take antibiotics to treat infection, or have a blood transfusion| if you are anaemic. You will have regular blood tests between courses of treatment to monitor the effects.
Other common side effects include tiredness| and weakness, feeling sick|, a sore mouth|, hair loss|, diarrhoea or constipation, and numbness and tingling| of the hands and feet. Medicines can be given to control some of these effects. The side effects will gradually disappear once the treatment has finished.
Hormonal therapies| are drugs that can stop or slow the growth of cancer cells by either changing the level of particular hormones in the body, or preventing the hormones affecting the cancer cells. Most hormonal therapies are given as tablets, but some are given as injections every few weeks or months.
Hormonal therapies can cause side effects such as weight gain, hot flushes, sweats, tiredness, and lowered sex drive. These treatments are usually given for months or years and they usually have less of an effect on your ability to work than other cancer treatments.
These are a newer group of treatments that work by targeting the growth of cancer cells. They generally have little effect on normal cell growth, so they usually have less troublesome side effects than cytotoxic drugs. Targeted therapies may be given as a drip (intravenous infusion) or as tablets.
Possible side effects include flu-like symptoms, chills, headaches, a temperature, low resistance to infection and tiredness (fatigue). Some treatments may also cause sickness and diarrhoea. Many people are able to carry on working while taking these drugs, but tiredness and other side effects may sometimes make this difficult.
Many people recover quickly and can live a normal life once their treatment has ended. However, some people will have ongoing problems caused by their treatment, for example:
If you have long-term side effects from your treatment, you may need a lot of understanding and support from your employer. Things that your employer can do to help you| are discussed later.Many people recover well and can return to a normal working life after their treatment has ended. However, others will have ongoing problems caused by their treatment. For example:• tiredness for months or sometimes years• soreness of an arm after breast surgery• needing to eat little and often after stomach surgery• needing to go to the toilet more often after bladder or bowel cancer treatment.If you have long-term side effects from your treatment, you may need a lot of understanding and support from your employer. We discuss things they can do to help you on pages 30–31.
Sometimes two different types of treatment may be equally effective in treating your cancer, but have different side effects and so will have different effects on your day-to-day life and your ability to work.
Doctors and other healthcare professionals can give you detailed advice about the individual treatments and how each will affect your ability to work. However, the final decision on which treatment to have, or whether to have treatment, should be yours.
It can be very helpful to find out as much as possible about the type of cancer you have and the treatments which are planned. You can then work closely with your doctors and be involved in choosing the treatment that best suits your situation.
You can discuss the benefits and possible risks of each treatment with the health professionals looking after you. It is important to remember that it can be very difficult to predict how treatment will affect a person. This is because the same treatment can affect people differently. An example is that for two people given the same dose of the same chemotherapy drug, one may have very few side effects and be able to carry on working. The other person may have severe side effects and be unable to work for a while.
Once you have the answers to these questions, you may need time to think through your choices, and discuss them with your family or friends.
If you find it difficult to decide between the treatment options, it may help to talk to people who have already had those treatments. Your doctor may be able to put you in touch with other patients.
Many cancer organisations and support groups can also help you to find someone who has had a particular treatment.
It is often possible to find information about cancer and its treatment on the internet; however there is also a lot of misleading or inaccurate information. If you look for information on the internet it is important to use only high-quality and reputable sites.
Some people prefer to leave treatment decisions completely to their doctors, as they find this easier and less stressful. However, even if you decide to do this, it is helpful to take the time to understand what your treatment will involve and how it will affect your ability to work.
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If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.
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