The prospect of embarking upon a journey through cancer treatment is often made more difficult because we have little knowledge about how it works and what it ‘looks like’. This can contribute to a sense of fear and trepidation, because it is a journey into the unknown. Before you start any treatment, your doctors will explain the planned course of action to you but it is still natural to feel daunted, not least because you are still trying to come to terms with your cancer diagnosis and the changes this has brought to your life. Don’t ever feel afraid to ask doctors or nurses questions or to repeat explanations to you if you feel you haven’t fully grasped or absorbed what they have told you. It is very important that you come to understand the nature of your treatment and the potential outcome.
Although progress is being made in newer therapies, the most common treatments for cancer are
surgery
radiotherapy
The intent behind treatment can be ‘curative’ or ‘palliative’. Treatment whose intent is curative aims to cure a patient completely of his cancer, so that no evidence of it remains and he returns to normal health. A cure means that all evidence of your cancer is eliminated and that it will not return. However, the term ‘cure’ can only be applied with confidence after the passage of time – in the majority of cases, after five years. ‘Palliative’ treatment does not aim to cure, but the term can be used in two different contexts. First, palliative treatment can be used to shrink a tumour and thereby improve the patient’s quality of life. This does not necessarily mean that you have only a short time to live, but rather that it is not thought possible to eradicate your cancer completely: for example, the majority of men with prostate cancer actually die from something other than their cancer. Second, palliative care may be used purely to control and alleviate the symptoms of cancer where no other treatment options are available. It is important for you to clarify with your doctor the intent behind your treatment. This may be a difficult question to ask, and indeed a difficult question for your doctor to answer, but you will be better prepared to cope with your treatment if you understand what it is intended to achieve. The terms such as ‘cure’ or ‘remission’ which your doctors may use in discussing the intent behind your treatment are described in more detail in Chapter 4.
A tremendous amount of research has been carried out in recent decades to establish the most effective type of treatment for individual cancers. Just as there are several hundred different forms of the disease, so there are many ways in which treatment can be geared to your particular cancer. Different cancers behave and react in different ways, so the appropriate treatment for, say, bowel cancer will not be the same as the treatment for lung cancer. You may have a single type of treatment or a combination of treatments, say, surgery followed by chemotherapy or radiotherapy, but you can be assured that the decision as to which is most appropriate for you will be based on the most effective proven treatment for your particular circumstances.
Once your cancer has been diagnosed, treatment often starts very quickly and it is easy to feel that you are being carried along by events beyond your control and understanding. Finding out as much as you can about your proposed treatment and, just as importantly, about any anticipated side-effects, can help you to regain some sense of control. Building up knowledge does take time, especially in such difficult circumstances, but knowing what to expect will help you to cope better once the treatment is underway.
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