Sr Rowan Robinson shares part two of her oncology literacy 101 series which focuses on cancer treatments.
In the turmoil of being diagnosed with cancer, an important discussion between yourself and your oncologist needs to take place about treatment options.
While some patients may prefer not to know too much and rather go ahead with any recommendations given, others may find it helpful to prepare themselves for the journey ahead and ask questions.
Choice of treatment
There are several factors that may influence the choice of treatment offered. Your doctor will consider the type of cancer you have including the grading and staging of the disease, the size and location of the tumour, as well as research and experience: what treatments or combination of treatments are recommended in similar circumstances.
Your age will also be considered and whether you would want fertility to be preserved. The doctor will assess your general well-being and whether you have any other ailments that may influence your ability to tolerate treatment.
There are also ethical considerations as all patients have rights and responsibilities relating to their own health and well-being. This is set out in the Patient’s Bill of Rights. You have a right to information at a level that is understandable so that you can make informed choices.
Part of this may include financial considerations, as so many of the cancer treatments are very expensive.
The goal of your treatment
It’s important to understand the goal of your treatment at each point in your cancer journey. The first goal of treatment would be to cure or remove the disease completely, allowing you to live a normal lifespan. Cancer treatments would be given to get you into remission, which can either be partial or complete. In a complete remission, all evidence of your cancer has disappeared and if remission is retained for more than five years, some doctors may say that you have been cured.
Unfortunately, this may not always be achievable. Therefore, a second goal may be to control the disease from spreading further, minimise the signs and symptoms of the disease and prolong life for as long possible.
When cure or control of the disease isn’t possible, a third goal would be to provide comfort by relieving symptoms, such as pain, nausea or constipation, and to address emotional issues to improve quality of life so that life can be lived to its fullest potential to the end.
Palliative treatments are used for comfort and can, in fact, be given at any stage from diagnosis to terminal care, and through to recovery.
The available treatment options for cancer typically include surgery, radiotherapy, chemotherapy and immunotherapy.
Surgery is the oldest localised treatment for cancer and is often the first treatment for many cancers. It’s used throughout the cancer journey for diagnosis, staging, treatment, reconstruction and even prevention of disease.
Radiation is also a localised treatment. It uses particles of high-energy that travel in waves, which enter the body causing damage to all cells in the wave’s path, through a process called ionization. This damage interferes with the cell’s ability to reproduce. A precisely measured dose of radiation can be delivered to a defined tumour volume with as little damage as possible to surrounding healthy tissue. The clinical use of radiation has led to the speciality of radiation oncology.
Chemotherapy is the use of chemicals or drugs as a systemic treatment for cancer. The drugs interfere with the cell cycle of healthy and malignant cells, causing many side effects. The use of these drugs to treat cancer has led to the specialisation of medical oncology.
Immunotherapy or biotherapy uses medicines that affect your immune system. These drugs help your immune system fight off the cancer by recognising the malignant cells and then injuring, killing or preventing these cells from reproducing.
Surround yourself with trusted family and friends
Throughout your personal cancer journey, it’s important to remember that you’re an individual and you’ll respond to your treatment in your own unique way. No two people will respond the same, even if they have the same diagnosis, prognosis and treatment. Therefore, surround yourself with trusted family and friends that will encourage and support you throughout this life-changing experience.
MEET THE EXPERT – Sr Rowan Robinson
Sr Rowan Robinson is an oncology/haematology nurse and educator with over 20 years’ experience. She currently leads a team of oncology nurse navigators at the Cancer Care Division of Netcare Ltd. She is passionate about caring for patients with cancer and finding ways to improve their journey within the healthcare system.
Header image by Freepik
Mayo Clinic 2020. “Cancer treatment”. Available: https://www.cancer.gov/about-cancer/diagnosis-staging/prognosis#:~:text=Remission%20means%20that%20the%20signs,say%20that%20you%20are%20cured
National Cancer Institute 2020. “Understanding the difference between cure and remission”. Available: https://www.cancer.gov/about-cancer/diagnosis-staging/prognosis#:~:text=Remission%20means%20that%20the%20signs,say%20that%20you%20are%20cured
Otto, S. 2001. “Surgery”, Oncology Nursing, 4th ed, pp. 585-594. Mosby, Missouri
Wilkes, G.M. 2011. “Chemotherapy: principles of administration”, In Yarbro, C., Wujcik, D. & Gobel, B., Cancer nursing: principles and practice, 7ed. Massachusetts: Jones & Bartlett.