What treatment is available? Treatment usually begins soon after cancer is diagnosed. You can discuss all the options with your doctors and nurses, and they must take your wishes into account .

In this article

Planning your treatment Surgery

Radiotherapy Chemotherapy

Other treatments Complementary approaches

The main types of treatment are surgery, radiotherapy and chemotherapy. For some cancers, combinations of all three may be used.

Sometimes no treatment is most appropriate. Your doctor may advise you to wait and see what happens (this is sometimes referred to as 'watchful waiting'). You may want to ask your doctor why she is recommending this approach.

As you plan your treatment, your specialist (the doctor coordinating your tests and treatment) will consider your general health as well as the stage of the disease (known as 'staging'). Knowing the stage of the disease will help provide an idea of how it will develop and what treatment, if any, is most appropriate.

If surgery, radiotherapy or chemotherapy is recommended, you'll be asked to sign a consent form agreeing to this treatment. Do ask your doctors and nurses questions about this, and only sign the form if you're satisfied you have answers to everything you want to know.

If the effects of the treatment worry or upset you, it's important to tell the staff who are treating you. They may be able to do something to help.

This usually aims to remove as much as possible of the cancer growth, ideally all of it. You'll probably want to discuss the procedure with your doctor. Sometimes surgery is carried out to treat the complications of cancer, rather than remove the tumour itself. For example, when a tumour is pressing on a vital organ or nerve, or blocking a tube such as the intestines, an operation can help to relieve symptoms.

Occasionally, during an operation to remove cancer, the surgeons find (once they are able to see inside the body) that the tumour has spread so far that surgery would not be successful and they simply close the wound up again without doing any more.

Some hospitals have specialist nurses who can talk to you about the operations and their effects.

Radiotherapy uses high energy rays to destroy cancer cells. Treatment can be given either from outside the body or from within, by placing a radioactive material close to the tumour. Receiving radiotherapy doesn't usually involve staying in hospital, but a series of visits instead.

The treatment is painless, but there can be side-effects. Some people feel tired and low, very nauseous or get swellings, and many get a skin reaction similar to sunburn in the area being treated. Most side-effects should disappear soon after treatment has ended but, very rarely, they can be severe and long term.

Ask the doctor

"My father has bone cancer, what can we do to relief the pain?"
"My husband is having chemotherapy, what can I do to improve his appetite?"

Chemotherapy is a treatment that uses strong drugs to destroy cancer cells. The drugs are often given by injection or drip. This treatment sometimes involves a stay in hospital.

New drugs are continually being developed, increasingly targeted at the type of cells causing cancer in that individual patient. So, for example, women with breast cancer will be tested to check what is known as their “receptor status”. This means finding out whether the cancerous cells carry structures on their surface that make them receptive to the effects of different female sex hormones. For example, cells that are receptive to oestrogen (known as oestrogen-receptor positive) can then be treated with anti-cancer drugs that block the effects of oestrogen.

If the cells carry a receptor known as her2neu (a growth-stimulating protein), they will be sensitive to the effects of a new cancer treatment called Herceptin. This is not a chemotherapy drug, although it is often given at the same time.

Chemotherapy can have side-effects because the drugs cause damage to healthy cells as well as cancerous ones. These can include hair loss, tiredness, nausea, vomiting and a lowering of immunity. People's sex lives can also be affected. There are medicines that can help reduce some of these unwanted effects.

Other forms of treatment include hormone therapy, bone marrow transplants and peripheral blood stem transplants - see medical terms. There are several specialised treatments for particular types of cancers, and new treatments are continually being researched. Your doctors and cancer organisations will be able to provide you with more details.

Practitioners of complementary care usually take a holistic approach and try to support cancer patients through their treatment and after.

Some people find complementary therapies help reduce the side-effects of conventional treatments as well as helping to reduce stress.

Although some complementary approaches are available through the NHS and many doctors think they can be useful, they're not always accepted by the medical establishment.

This is partly because, until recently, they haven't been subject to the strict medical trials by which doctors prove a treatment works. On the other hand, many people who've had cancer say they've felt benefits.

If you decide on complementary therapy, it's important to tell your doctor, who'll probably be supportive of your decision. If not, you could ask if they have valid medical reasons against your choice.

Some people decide to have complementary care instead of, rather than alongside, conventional medical care. Unless your doctor feels conventional treatment is no longer appropriate, they will probably not be enthusiastic about your choice.

Before taking this course of action, it's important to discuss it carefully with those close to you, your doctors, complementary practitioners and cancer support groups.

This article was last medically reviewed by Dr Trisha Macnair in September 2006.
First published in February 1999.