In most cases, the surgeon removes the tumor and some tissue around it. Removing nearby tissue may help prevent the tumor from growing back. The surgeon may also remove some nearby lymph nodes.
The side effects of surgery depend mainly on the size and location of the tumor, and the type of operation. It takes time to heal after surgery. The time needed to recover is different for each type of surgery. It is also different for each person. It is common to feel tired or weak for a while.
Most people are uncomfortable for the first few days after surgery. However, medicine can help control the pain. Before surgery, you should discuss the plan for pain relief with the doctor or nurse. The doctor can adjust the plan if you need more pain relief.
Some people worry that having surgery (or even a biopsy) for cancer will spread the disease. This seldom happens. Surgeons use special methods and take many steps to prevent cancer cells from spreading. For example, if they must remove tissue from more than one area, they use different tools for each one. This approach helps reduce the chance that cancer cells will spread to healthy tissue.
Similarly, some people worry that exposing cancer to air during surgery will cause the disease to spread. This is not true. Air does not make cancer spread.
Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. Doctors use several types of radiation therapy. Some people receive a combination of treatments:
- External radiation: The radiation comes from a large machine outside the body. Most people go to a hospital or clinic for treatment five days a week for several weeks.
- Internal radiation (implant radiation or brachytherapy): The radiation comes from radioactive material placed in seeds, needles or thin plastic tubes that are put in or near the tissue. The patient usually stays in the hospital. The implants generally remain in place for several days.
- Systemic radiation: The radiation comes from liquid or capsules containing radioactive material that travels throughout the body. The patient swallows the liquid or capsules or receives an injection. This type of radiation therapy can be used to treat cancer or control pain from cancer that has spread to the bone. Only a few types of cancer are currently treated in this way.
The side effects of radiation therapy depend mainly on the dose and type of radiation you receive and the part of your body that is treated. For example, radiation to your abdomen can cause nausea, vomiting and diarrhea. Your skin in the treated area may become red, dry and tender. You also may lose your hair in the treated area.
You may become very tired during radiation therapy, especially in the later weeks of treatment. Resting is important, but doctors usually advise patients to try to stay as active as they can.
Fortunately, most side effects go away in time. In the meantime, there are ways to reduce discomfort. If you have a side effect that is especially severe, the doctor may suggest a break in your treatment.
Chemotherapy is the use of drugs that kill cancer cells. Most patients receive chemotherapy by mouth or through a vein. Either way, the drugs enter the bloodstream and can affect cancer cells all over the body.
Chemotherapy is usually given in cycles. People receive treatment for one or more days. Then they have a recovery period of several days or weeks before the next treatment session.
Most people have their treatment in an outpatient part of the hospital, at the doctor's office or at home. Some may need to stay in the hospital during chemotherapy.
Side effects depend mainly on the specific drugs and the dose. The drugs affect cancer cells and other cells that divide rapidly:
- Blood cells: When drugs damage healthy blood cells, you are more likely to get infections, to bruise or bleed easily, and to feel very weak and tired.
- Cells in hair roots: Chemotherapy can cause hair loss. Your hair will grow back, but it may be somewhat different in color and texture.
- Cells that line the digestive tract: Chemotherapy can cause poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores.
Some drugs can affect fertility. Women may be unable to become pregnant, and men may not be able to father a child.
Although the side effects of chemotherapy can be distressing, most of them are temporary. Your doctor can usually treat or control them.
Targeted cancer therapies are drugs or other substances that block the growth and spread of cancer by interfering with specific molecules involved in tumor growth and progression. Because scientists often call these molecules “molecular targets,” targeted cancer therapies are sometimes called “molecularly targeted drugs,” “molecularly targeted therapies” or other similar names. By focusing on molecular and cellular changes that are specific to cancer, targeted cancer therapies may be more effective than other types of treatment, including chemotherapy and radiotherapy, and less harmful to normal cells.
Many targeted cancer therapies have been approved by the U.S. Food and Drug Administration for the treatment of specific types of cancer (see details in Questions 4 and 5). Others are being studied in clinical trials (research studies with people) and many more are in preclinical testing (research studies with animals).
Targeted cancer therapies are being studied for use alone, in combination with other targeted therapies, and in combination with other cancer treatments, such as chemotherapy.
Stem Cell Transplantation
Transplantation of blood-forming stem cells enables patients to receive high doses of chemotherapy, radiation or both. The high doses destroy both cancer cells and normal blood cells in the bone marrow. After the treatment, the patient receives healthy, blood-forming stem cells through a flexible tube placed in a large vein. New blood cells develop from the transplanted stem cells. Stem cells may be taken from the patient before the high-dose treatment, or they may come from another person. Patients stay in the hospital for this treatment.
The side effects of high-dose therapy and stem cell transplantation include infection and bleeding. In addition, graft-versus-host disease (GVHD) may occur in people who receive stem cells from a donor. In GVHD, the donated stem cells attack the patient's tissues. Most often, GVHD affects the liver, skin or digestive tract. GVHD can be severe or even fatal. It can occur any time after the transplant, even years later. Drugs may help prevent, treat or control GVHD.
For more information about treatments related to a specific cancer type, please visit the specific cancer type page.