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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 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, the tiredness can take longer to disappear and some people find it’s many months before they regain their energy.
We have more information about the possible side effects of radiotherapy|.
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 more than 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 chemotherapy drugs are taken as tablets or capsules, which can be taken at home.
Chemotherapy is usually given in cycles of treatment. The drug (or drugs) is given, 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 take from 4-8 months. Some treatments for particular types of cancer last much longer than this, while 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.
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 after their 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 nosebleeds or bruise easily.
If the bone marrow isn’t 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.
Targeted therapies|, also known as biological therapies, 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, lowered 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 well and can return to a normal working life after their treatment has finished. However, others 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|.
Sometimes two different types of treatment may be equally effective in treating cancer, but have different side effects.
Doctors and other healthcare professionals can give you information about the individual treatments and how each may affect your day-to-day life and ability to work.
The final decision about which treatment to have, or whether to have treatment at all, is yours.
It can help to find out as much as possible about the type of cancer you have and the treatments that are planned. You can then discuss the benefits and possible risks with your doctors and decide on the treatment that best suits your situation.
It’s important to remember that it can be difficult to predict how treatment will affect a person. This is because the same treatment can affect people differently. For example, two people may be given the same dose of the same chemotherapy drug; one may have few side effects and be able to carry on working, while 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 find someone who has had a particular treatment. Some websites have video clips of people talking about their experiences of treatment.
If you like talking to people online, you can join a discussion group on our online community|.
Many people use the internet to find information about cancer and its treatment. However, there’s a lot of misleading or inaccurate information, so it’s important to use high-quality and reputable sites. We have a list of other useful organisations| which you may find helpful.
Your medical team uses national treatment guidelines to decide the most suitable treatment for you. Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion. Getting a second opinion may delay the start of your treatment, so you and your doctor need to be confident that it will give you useful information.
If you do go for a second opinion, it may be a good idea to take a relative or friend with you, and have a list of questions ready so that you can make sure your concerns are covered during the discussion. It’s helpful to take the time to understand what your treatment will involve and how it will affect your ability to work.
Content last reviewed: 1 May 2011
Next planned review: 2013
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.
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© Macmillan Cancer Support 2013
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