Being prepared and understanding chemotherapy can help lessen some of the stress surrounding your treatment. Ask your oncologist, doctor or nurse any questions you have about the risks and benefits of chemotherapy.
⯐ What is chemotherapy?
Chemotherapy (or “chemo”) is the use of anti-cancer drugs to destroy cancer cells. Combination therapy is when a number of drugs may be given at the same time. Sometimes only one drug is used. Chemotherapy may be used before or after surgery or radiation therapy, or together with radiation therapy.
⯐ How is chemotherapy given?
How chemotherapy is given will depend on the type of cancer being treated and the drugs being used. Treatment may be given:
◉ Orally
◉ Through a needle inserted into a vein, slowly injecting the medication through a catheter (a special tube), placed in a large vein, usually in the neck or chest which remains there throughout the course of the treatment
◉ By introducing drugs directly into an organ or tissue affected by cancer as a cream you apply to your skin.
⯐ Is chemotherapy painful?
Chemotherapy should cause no discomfort, although having a needle inserted into a vein may feel like giving blood.
The initial injection for a temporary tube (cannula) may be uncomfortable.
If at any time a chemotherapy injection hurts or burns, immediately tell the nurse who is giving you the drug.
If after your treatment you notice some tenderness develop over the injection site, contact the chemotherapy unit immediately.
⯐ Why is chemotherapy given?
Chemotherapy may be used:
◉ To cure cancer. With some types of cancer, chemotherapy will destroy all the cancer cells and cure the disease
◉ To reduce the chance of the cancer coming back. Chemotherapy may be given after surgery or radiation therapy to destroy any remaining cancer cells that are too small to see
◉ To shrink a cancer prior to surgery or radiation therapy, to increase the success of your primary treatment
◉ To shrink a cancer, to improve symptoms and to prolong life in cases where cure is not possible.
⯐ How often and how long is chemotherapy?
It depends on the type of cancer you have, the way it responds to treatment and your ability to tolerate the treatment. Your doctor will talk to you about the time period planned for your course of treatment. You may have chemotherapy over 3 to 6 months but treatment may also be shorter or longer.
You will usually have several treatment cycles with periods of rest in between to allow normal cells to recover. These can be given over a few days, weeks or months, and some on a long-term basis.
Maintenance chemotherapy to prevent cancer coming back; and palliative treatment to control the cancer, may continue for months or even years.
If you are worried about how long the treatment is taking or the impact of side effects, talk to your treatment team.
⯐ Where is treatment given?
Chemotherapy is usually given during the day as an outpatient in a hospital or treatment center. Sometimes a short stay in hospital is necessary if it is a longer or more complex chemotherapy treatment. In some cases, you can have chemotherapy treatment at home.
⯐ Chemotherapy side effects
Chemotherapy can produce side effects in some but not all people. Different chemotherapy drugs cause different side effects. Most are often temporary and can be treated or managed. Possible side effects include:
◉ Nausea and vomiting
◉ Diarrhea or constipation (often due to anti-nausea medication)
◉ Fatigue (tiredness)
◉ Anemia
◉ Increased risk of infection
◉ Increased risk of bruising
◉ Muscle weakness
◉ Skin sensitivity to sunlight (specific drugs only)
◉ Changes to the nails
◉ Dry or tired eyes
◉ Changes in fertility
◉ Thinking and memory changes.
Having any of the above side effects is not related to whether the chemotherapy is working or not.
Remember, if you have any concerns or questions, please contact your doctor.
Radiation therapy, also known as radiotherapy, is one of the main treatments for cancer. Being prepared and understanding radiation therapy can help lessen some of the stress surrounding your treatment. Ask your oncologist, doctor or nurse about the risks and benefits of radiation therapy and any other questions you have about your treatment.
⯐ What is radiation therapy used for?
Radiation therapy uses x-rays to destroy or injure cancer cells so they cannot multiply. Radiation therapy can be used to treat the primary cancer or advanced cancer.
It can also be used to reduce the size of the cancer and relieve pain, discomfort or other symptoms.
⯐ When is radiation therapy used?
Radiation therapy may be the main treatment, or may be used to assist another treatment. Adjuvant radiation therapy may be used to shrink the cancer before surgery, or after surgery, to stop the growth of any remaining cancer cells. In some cases it is used with chemotherapy.
⯐ Why is radiation therapy given?
Radiation therapy may aim to:
◉ Cure – some cancers can be cured by radiation therapy alone or combined with other treatments.
◉ Control – radiation therapy can control some cancers by making them smaller or stopping them from spreading.
◉ Help other treatments – radiation therapy can be used before or after other treatments to make them more effective.
◉ Relieve symptoms – if cure is not possible, radiation therapy may be used to reduce cancer symptoms and prolong a good quality of life.
⯐ How is radiation therapy given?
Radiation therapy is given from outside (external beam) or inside the body (brachytherapy). In external beam radiation therapy, a machine directs radiation at the cancer and surrounding tissue. In internal radiation therapy, radioactive material is put in thin tubes and placed in your body near the cancer.
⯐ Where will treatment take place?
Radiation therapy is usually given in private clinics or large hospitals. Treatment is given by trained staff called nuclear medicine specialists or radiation therapists. The treatment will be supervised by radiation oncologists who are the main treating medical specialists for people getting radiation therapy.
⯐ How long is a course of treatment?
Your treatment will depend on what sort of cancer you have, where it is, its size, your general health and other cancer treatments you may have had. Some people need only one treatment, while others need radiation therapy five days a week for several weeks. If you have internal radiation therapy the implants may be left in place for a few minutes, one to six days or permanently.
⯐ Does radiation therapy hurt?
External radiation therapy won’t hurt. You won’t see or smell the radiation, however you may hear a buzzing sound when the machine is on. You will NOT be radioactive. It is safe to be in contact with other people, including pregnant women and children, when you are having treatment and afterwards.
During internal radiation therapy you may experience a little discomfort from the implant, however you should not have any severe pain or feel ill. While your radioactive implant is in place, it may send some radiation outside your body. There will be limits on visitors while your implant is in place.
⯐ What are the side effects of radiation therapy?
Side effects vary and will depend on which area of your body is being treated. Possible side effects include:
◉ Dry, red or itchy skin
◉ Loss of appetite
◉ Nausea (feeling sick)
◉ Digestive problems
◉ Cough or shortness of breath.
Most side effects can be managed and will gradually disappear once your treatment has finished.
⯐ How long will side effects last?
In time, most side effects go away. However, some may be permanent and others may not appear until after treatment has finished.
If the side effects are severe, the radiation oncologist may change the treatment or prescribe a break. If the doctor thinks pausing treatment could affect how well the treatment is working then a break may not be possible.
⯐ How will I know the treatment has worked?
After treatment finishes, you will have regular check-ups with your doctor. You will have a physical examination, and you may have scans or tests to check whether the cancer has responded to treatment. It may take some time after your radiation therapy treatment has finished before the full benefit is known.
Your medical team won’t be able to give you progress updates during treatment because cancer cells continue to die for weeks or months after treatment ends. They can, however, help you manage any side effects.
If radiation therapy is given as palliative treatment, the relief of symptoms will indicate that the treatment has worked. This may take a few days or weeks.
⯐ Will radiation therapy affect my fertility?
Having radiation therapy in areas near your reproductive organs can affect your fertility temporarily or permanently.
Discuss this possibility with your doctor or specialist.
Remember, if you have any concerns or questions, please contact your doctor.
⯐ Can I have radiation therapy if I am pregnant?
If you are pregnant, you will probably not be able to have radiation therapy, as radiation can harm a developing baby. It’s important that you don’t become pregnant during treatment. Men who have radiation therapy should avoid getting their partner pregnant during treatment and for about six months afterwards, as radiation can damage sperm. Your doctor will be able to give you more information about radiation therapy and pregnancy.
⯐ Will I be able to work during radiation therapy?
Some people can continue to work during radiation therapy treatment, while others may need to reduce their hours or take time off. How much you are able to work depends on the type of radiation therapy you have, how the treatment makes you feel and the type of work you do. Your treatment team will encourage you to be as active as possible, and they can answer your questions about working during treatment.
⯐ Will I be radioactive?
External radiation therapy does not make you radioactive because the radiation does not stay in your body during or after treatment. You will not need to take any special precautions with bodily fluids, and it is safe for you to be with family, friends, children and pregnant women.
⯐ Which health professionals will I see?
Your treatment team will be made up of health professionals who care for people having radiation therapy. You will also see other health professionals who specialize in diagnosing and treating the type of cancer you have.
These may include:
◉ Radiation oncologist
◉ Radiation therapist
◉ Medical physicist
◉ Radiation oncology nurses
◉ Dietitian
◉ Social worker/psychologist
◉ Physiotherapist/occupational therapist.
Surgery is one of the main treatments for cancer. It may be used by itself or with other cancer treatments. It’s natural to feel nervous before surgery. Knowing what to expect, how to plan for surgery and the recovery process can help.
⯐ What is surgery?
Surgery is a medical treatment performed by a surgeon to remove cancer from the body or repair a part of the body affected by cancer. It’s sometimes called an operation or surgical resection.
⯐ How is surgery used for cancer?
Surgery is commonly used to:
◉ Confirm a cancer diagnosis. The doctor may remove all or part of a tumor in a procedure called a biopsy
◉ Investigate the size of the tumor and if the cancer has spread. This process is called staging and is often used to guide treatment decisions
◉ Treat small, early-stage cancers that haven’t spread. This may be the only treatment, or it may be combined with other treatments
◉ ‘Debulk’ the tumor if it is not possible to remove the cancer without damaging nearby healthy organs. This involves removing as much of the tumor as possible to make other cancer treatments more effective.
⯐ Surgery can also be used to:
◉ Prevent cancer (prophylactic surgery)
◉ Repair tissues damaged by tumour removal (reconstructive surgery)
◉ Insert a tube to allow the delivery of chemotherapy (supportive surgery), or
◉ Ease the symptoms of cancer and cancer treatment (palliative surgery).
⯐ How is surgery done?
The way the surgery is done depends on the type of cancer, its location, the surgeon’s training and the equipment available.
Types of surgical techniques used for cancer include:
◉ Open surgery, where the surgeon makes a single cut into the body to remove cancerous tissue
◉ Keyhole surgery, where the surgeon makes a few small cuts in the body and inserts a camera and light to guide the surgery. This may involve the use of robotics
◉ Laser surgery, where a laser is used to remove or destroy cancerous tissue
◉ Cryosurgery (or cryotherapy), which is often used to treat skin cancers. Liquid nitrogen is sprayed on to the skin to freeze and kill the cancerous tissue.
⯐ Will I stay in hospital?
You may be admitted to hospital as an inpatient to have surgery. The length of your stay depends on the type of surgery you have, the speed of your recovery and whether you have support at home.
It may be possible to have surgery during the day as an outpatient. This means you don’t have to stay overnight in hospital, provided there are no complications.
Your doctor will tell you whether you will have surgery as an inpatient or outpatient at one of your pre-surgery appointments.
⯐ What other treatments might I have?
Depending on your diagnosis, you may have other treatments, such as chemotherapy or radiation therapy.
These treatments can be given before (neo-adjuvant therapy), during (simultaneous therapy) or after surgery (adjuvant therapy).
⯐ How long will it take to recover?
The type of surgery you have and your overall health will determine how long you take to recover. It may take less than a week to recover from a simple operation, but it can take a few months to recover from major surgery.
Follow your surgeon’s advice, and try to be patient and allow yourself time to recover.
⯐ What are the possible side effects?
Possible side effects from surgery include pain and discomfort, as well as side effects from the general anesthetic (nausea, vomiting, dizziness and agitation).
Sometimes complications such as infection, bleeding and blood clots occur after surgery. Most complications are minor and can be treated easily. Talk to your surgeon about your actual risks.
⯐ Will I need to have more than one operation?
If the tissue surrounding the tumour, called the surgical margin, is clear of cancer, you may not need further surgery. If there are cancer cells present in the margin, you may require more treatment, which can include additional surgery.
⯐ Will I need to have more than one operation?
If the tissue surrounding the tumour, called the surgical margin, is clear of cancer, you may not need further surgery. If there are cancer cells present in the margin, you may require more treatment, which can include additional surgery.
During your cancer journey you may hear about, or become interested in, complementary therapies. There are many therapies on offer and information about these can be confusing. The information below will help you to make informed and safe choices.
⯐ What are conventional cancer therapies?
These are treatments that are evidence based and scientifically proven to be safe and effective. They are designed to diagnose and treat cancer, slow its growth, or provide relief from symptoms.
The main conventional treatments are surgery, radiation therapy, chemotherapy, hormone therapy and immunotherapy. They are often referred to as mainstream medical treatments.
⯐ What are complementary therapies?
Complementary therapies may be used together with conventional medical treatments to support and enhance your quality of life and wellbeing. They do not aim to cure the person’s cancer. Instead they are used to help control symptoms such as pain and fatigue.
Complementary therapies include relaxation, talking therapies, meditation, visualization, acupuncture, aromatherapy, reflexology, music therapy, art therapy and massage.
Some complementary therapies may not be recommended during your treatment as they interfere with your treatment and/or worsen side effects.
Always talk to your doctor before starting any complementary therapy.
⯐ What complementary therapies help cancer patients?
The following complementary therapies are those most often used by people with cancer.
◉ Touch therapies involve working with the physical body and include acupuncture, aromatherapy, reflexology and massage.
◉ Mind body therapies are designed to enhance the mind’s capacity to affect the body’s function and symptoms and include meditation, guided imagery and hypnosis.
◉ Talking therapies offer emotional support. This can be one-on-one with a trained counsellor, or in a group of people who come together to share their experiences and support each other. There are also peer support programs that connect you or your family member with a trained volunteer who has had a similar experience.
◉ Lifestyle approaches such as a healthy diet and regular exercise may help you feel better or help to relieve symptoms such as fatigue.
⯐ Considering a complementary therapy?
Find out as much information as you can about the therapy by asking questions such as:
◉ Is this therapy specifically used for cancer patients or for people with other diseases?
◉ Are there any side effects?
◉ Who will be involved in delivering the therapy?
◉ What are the practitioner’s qualifications, and are they registered with a professional organization?
◉ What are the costs of the therapy and are they covered by my health insurance provider?
◉ What does the therapy aim to achieve?
◉ Will this therapy affect my conventional medical treatment?
You should always feel safe, comfortable and respected when undertaking any form of complementary therapy.
Your state or territory Cancer Council may offer a range of complementary therapies and answer any questions you have. Remember, if you have any specific concerns or questions, please contact your doctor.
Hormone therapy may also be called endocrine therapy or hormone-blocking therapy.
Some cancers grow in response to particular hormones. These cancers are known as hormone-dependent cancers. They include some types of breast, uterine and prostat
⯐ What are hormones?
Hormones are substances that are produced naturally in the body and affect how your body works. They act as messengers carrying information and instructions from one group of cells to another.
Hormones control many of the body’s functions, including how you grow, develop and reproduce. Examples include:
◉ The female sex hormones estrogen and progesterone, which control ovulation and menstruation
◉ The male sex hormone testosterone, which causes the development of the reproductive organs and other sexual characteristics, such as a deep voice and facial hair
◉ Thyroid hormones, including thyroxine, which control the body’s metabolism
⯐ What is hormone therapy?
Hormone therapy uses synthetic hormones to block the effect of the body’s natural hormones. The aim is to lower the amount of hormones the tumor receives. This can help reduce the size and slow down the spread of the cancer.
The treatment may be given as tablets you swallow or injections. For some cancers, you may have surgery to remove a part of the body to stop the production of hormones, e.g. your ovaries may be removed to stop the production of estrogen.
Hormone therapy to treat cancer is not the same thing as hormone replacement therapy (HRT). HRT supplies the body with hormones that it is no longer able to produce naturally and is often used to treat the symptoms of menopause. People who have had their whole thyroid removed will also need hormone replacement therapy as their body no longer produces thyroxine. Learn more about thyroid hormone replacement therapy.
⯐ When is hormone therapy given?
Hormone therapy is usually used with other cancer treatments:
◉ Before surgery or radiation therapy to shrink a tumor
◉ After treatment to reduce the risk of the cancer returning
◉ To slow the growth of cancer that has spread throughout the body and help manage symptoms
⯐ What are the side effects?
Hormone therapy is a systemic treatment, which means it can affect cells throughout the body.
As each hormone in the body has a specific function, altering the balance of hormones in the body can cause side effects. Whether or not you experience side effects, and how severe they are, depends on the type of hormone you are taking, the dose, and how long you take the treatment. Talk to your doctor about the risks and benefits of taking hormone therapy.
Common side effects include tiredness, hot flushes, mood changes, weight gain and sweating. Hormone therapy can also affect the fertility of both women and men, bring on menopause, and have an impact on your sexuality.
Hormone therapy may also cause bones to weaken and break more easily (osteoporosis). Talk to your doctor about having a bone density test or taking medicine to prevent your bones from becoming weak. Regular exercise, eating calcium-rich foods (e.g. yoghurt, milk, tofu, green vegetables) and getting enough vitamin D will also help keep your bones strong.
⯐ Hormone therapy for breast cancer
Around 70-80% of breast cancers are sensitive to the hormones estrogen (ER) or progesterone (PR). This means that these hormones may be helping the cancers grow. These cancers are called hormone receptor positive (ER+ and/or PR+), and they are likely to respond to hormone therapy that blocks estrogen.
There are different ways to reduce the level of female hormones in the body, including anti-estrogen drugs, aromatase inhibitors, and ovarian treatments. The choice will depend on your age, the type of breast cancer and − for women − whether you have reached menopause.
Learn more about Hormone therapy for breast cancer.
⯐ Hormone therapy for cancer of the uterus
Some cancers of the uterus grow in response to estrogen.
Hormone treatment may be given if the cancer has spread or if the cancer has come back, particularly if it is a low-grade cancer. It is also sometimes offered in the first instance if surgery is not an option, for example, for women who still want to have children.
The main hormone treatment for estrogen-dependent uterine cancer is progesterone.
Learn more about Hormone treatment for cancer of the uterus
⯐ Androgen deprivation therapy for prostate cancer
Prostate cancer needs testosterone to grow. Testosterone is an androgen (male sex hormone), so hormone therapy for prostate cancer is called androgen-deprivation therapy (ADT).
ADT slows the production of testosterone, which may slow the cancer’s growth or shrink it temporarily. It may be recommended for locally advanced or advanced prostate cancer.
Learn more about androgen deprivation therapy for prostate cancer.
While chemotherapy works to kill cancer cells, immunotherapy aims to boost the body’s own immune system to fight cancer. Checkpoint immunotherapy is currently available in Australia for some types of cancer.
⯐ What is the immune system?
The immune system is made up of a network of cells and organs and is designed to protect the body from threats such as infections, toxins and abnormal cell development. The immune system recognizes when a foreign organism, such as a germ, enters the body and attacks it to stop if from harming the body.
Lymphocytes (white blood cells) are a key part of the immune system. There are two main types:
◉ B-cells which fight bacteria and viruses.
◉ T-cells which help control the immune system and help B-cells make antibodies.
The immune system usually prevents cancers from developing because of its ability to detect and eliminate abnormal cell growth. Sometimes the body’s natural immune system may not be strong enough to fight the cell growth that causes cancer. Cancer cells may also change over time, which can allow them to escape the immune system.
⯐ How does immunotherapy work?
There are different kinds of immunotherapy and they work in different ways. Immunotherapy can boost the immune system to work better against cancer or remove barriers to the immune system attacking the cancer.
⯐ Checkpoint inhibitors
Proteins called ‘checkpoints’ on the surface of T-cells can stop the immune system from attacking cancer cells.
Checkpoint inhibitors are drugs designed to block these proteins to enable the T-cells to recognize and destroy cancer cells. These types of drugs are currently the most widely used form of immunotherapy. Some are subsidized on the Pharmaceutical Benefits Scheme (PBS).
⯐ Immune stimulants
Some immunotherapy treatments aim to stimulate the immune system so it reactivates and attacks cancer cells.
⯐ CAR T-cell therapy
Chimeric antigen receptor (CAR) T-cell therapy boosts the ability of T-cells to fight cancer. These cells are removed from the blood and altered to better recognize cancer cells before being returned to the blood via intravenous drip.
CAR T-cell therapy is used for some types of leukemia and lymphoma and clinical trials are testing whether this type of therapy works for other types of cancer.
⯐ Oncolytic virus therapy
Oncolytic virus therapy uses viruses that infect cancer cells, causing them to die and stimulating the immune system to attack the cancer. This therapy is sometimes used to treat melanoma and clinical trials are testing oncolytic virus therapies for brain cancer and some other cancers. Research is in its early stages.
⯐ When is immunotherapy used?
Surgery, chemotherapy and radiotherapy are still the most widely used cancer treatments but checkpoint immunotherapy is likely to benefit some people with some types of cancer.
In Australia immunotherapy has been predominantly used for the following cancers:
◉ Bladder
◉ Kidney
◉ Melanoma
◉ Leukemia
◉ Liver
◉ Lung
◉ Lymphoma
⯐ How is immunotherapy treatment given?
How often and how long you receive immunotherapy may depend on:
◉ The type of immunotherapy
◉ The type of cancer
◉ How advanced the cancer is
◉ How you respond to treatment
◉ The side effects you may experience.
Checkpoint inhibitors are usually given with an injection into a vein (intravenously).
When immunotherapy is used to treat some melanoma cases, a cream called imiquimond may be applied directly to the affected area.
Sometimes more than one type of immunotherapy drug is prescribed. Immunotherapy drugs appear to keep working for varying periods of time, and in some cases, can keep working long after other treatments are no longer used.
⯐ What are the side effects of immunotherapy?
Side effects from immunotherapy can vary depending on the type of treatment you receive and how your body responds. The side effects of checkpoint immunotherapy are different from those of other cancer treatments.
Common side effects include:
◉ Fatigue
◉ Skin rash and itching
◉ Diarrhoea
◉ Abdominal pain
◉ Dry eyes
◉ Changes in weight and body temperature
◉ Joint pain.
Rare side effects include:
◉ Headaches
◉ Changes in vision
◉ Shortness of breath and coughing
◉ Fainting or chest pain
◉ Yellowing of the eyes
◉ Thyroid related issues
◉ Severe abdominal pain and dark urine
◉ Excessive thirst or urination
◉ Reduced urination or blood in the urine
◉ Muscle pain
◉ Confusion or seizures.
Palliative care is care that helps people live their life as fully and as comfortably as possible when living with a life-limiting or terminal illness.It is often given to people with advanced cancer but palliative care can be used at any stage when cancer is active.
⯐ What is palliative care?
The aim of palliative care is to enhance your quality of life and help you maintain your independence. It also provides support to families and carers.
The role of palliative care is to:
◉ Help you achieve the best quality of life
◉ Make sure your physical, practical, emotional and spiritual needs are met
◉ Help you make decisions about your treatment and ongoing care.
⯐ When can palliative care help?
Palliative care can help anyone with cancer who is experiencing physical or emotional discomfort.
Palliative care can help reduce cancer symptoms, which may include pain, fatigue, nausea and constipation, and can reduce side effects from cancer treatments.
Some people receive palliative care for several years as improved cancer treatments may be able to slow or stop the spread of advanced disease and relive symptoms even if it can’t be cured.
Palliative care can also help if you are experiencing depression or anxiety due to your cancer diagnosis. Counselling and support services can help address many fears, worries or conflicting emotions.
If you have advanced cancer, a social worker or counsellor can help you work out your goals and how best to achieve them. These goals may be specific end-of-life wishes, but can also simply involve making the most out of each day.
⯐ When can I start palliative care?
Palliative care can be started at any stage following a cancer diagnosis where the cancer is still active. Speak to your general practitioner, community nurse or cancer specialist about the palliative care services appropriate for you.
⯐ How do I get palliative care?
You will need a referral from your GP, medical specialist or other health professionals to access palliative care. Once you know that the cancer is an advanced stage, you can consider palliative care. Sorting out care sooner will help reduce stress on you and your family. This will also give you time to better understand and manage any physical symptoms such as pain or nausea, and consider your emotional, social, cultural and spiritual needs.
⯐ Where can I have palliative care?
You can have palliative care in different places, including:
◉ At home
◉ In a hospital
◉ At a residential aged care facility or other out-of-home facility
◉ In a specialist palliative care unit (hospice0.
Counselling can be given at home or at a local health service. Palliative treatment such as radiotherapy or surgery will be administered in a hospital or cancer centre.
The palliative care team will consider your care needs, your home environment, your support networks, and what organisations and individuals are available in your area. If you are cared for at home, you can be supported by community palliative care services.
Depending on your situation, it may not always be possible to stay at home. If this is the case, the palliative care team will talk to you and your carers about options for your ongoing care, which may include a hospital or palliative care unit.
⯐ Will I lose my independence?
Depending on your situation, you may need a little help with some things or more help with a lot of daily tasks. This is likely to change over time.
Your palliative care team will talk to you about practical ways you can maintain a sense of independence for as long as possible. They make some recommendations such as home modifications such as installing a ramp or handrails or loaning equipment such as a walking frame to help you conserve energy.
⯐ Who are the palliative care team?
Your palliative care team may be made up of medical, nursing and allied health professionals, volunteers and careers working closely with your general practitioner or family doctor, who offer a range of services to assist you, your family and carers throughout your illness.
The team may include your general practitioner, nurse, palliative care specialist, cancer specialist, counsellor, social worker, occupational therapist, physiotherapist, pharmacist and dietitian. Family members and other personal carers may also form part of the team.
Support may include visiting patients in a hospice or hospital setting, or speaking with patients and their family members about the diagnosis and treatment.
You will have regular appointments with the health professionals in your team so they can monitor you and adjust your care. You won’t necessarily see all the people listed; some roles overlap and assistance varies across Bangladesh.
⯐ Can I still have cancer treatment?
You can still have active treatment to shrink the cancer or stop it growing. The palliative care team will work with your cancer specialists to manage any side effects from treatment and maintain your quality of life.
Cancer treatment such as radiation therapy, drug therapies and surgery may also be used as part of palliative care. In this case, the aim is not to cure the cancer but to control it or relieve symptoms.
⯐ How long will I have palliative care for?
You and your palliative care team will determine how long you receive palliative care.
If you have advanced cancer you may be supported by palliative care services for months or years after your diagnosis.
Whatever stage you’re at, your team will continually assess your changing needs and adjust your care to suit.
⯐ Do I have to pay for palliative care?
The federal, state and territory governments fund a range of palliative care services that are free in the public health system whether you receive care in a hospital, residential aged care facility or at home.
You may need to pay part of the costs of care. This might include:
◉ Paying for medicines
◉ Hiring specialist equipment for the home
◉ Paying for nursing staff if you choose to stay at home and need 24-hour assistance
◉ Using short-term care (respite care) that charge a fee
◉ Paying the fee for a private allied health professional such as a physiotherapist or psychologist (check to see if you are eligible for a Medicare rebate)
◉ Paying for complementary therapies.
You can get more information by contacting your state or territory palliative care organization.
⯐ What is targeted therapy?
Targeted therapy is a type of drug treatment. It attacks specific cancer cell features, known as molecular targets, to stop the cancer growing and spreading.
Targeted therapy is sometimes called molecular targeted therapy and biological therapies.
⯐ How does targeted therapy work?
Targeted therapy drugs circulate throughout the body with each drug acting on a specific molecular target within or on the surface of cancer cells. As molecular targets are involved in the growth and survival of cancer cells, blocking them can kill cancer cells or slow their growth, while keeping damage to healthy cells at a minimum.
Targeted therapy drugs are used to control cancer growth and often cause the signs and symptoms of cancer to reduce or even disappear. The drugs may need to be taken long-term and will require you to have regular tests to monitor the cancer.
Targeted therapy is not suitable for everyone. Your doctors will test the cancer to see if the cells contain a particular molecular target. Different people with the same cancer type can receive different treatments based on their test results.
⯐ When is targeted therapy used?
The use of targeted therapy to treat cancer has improved survival rates for several types of cancer , and many people respond well.
Targeted therapy drugs have been approved for use in Australia for a number of cancer types. These include blood cancers such a lymphoma and leukemia; common cancers like breast, bowel, lung and melanoma; and other cancers such as head and neck, cervical, liver, kidney, ovarian, stomach, pancreatic, sarcoma and thyroid.
Many targeted therapy drugs aren’t safe to use during pregnancy or breastfeeding. Talk to your doctor about contraception or if you become pregnant.
⯐ What are the different types of targeted therapy?
There are two main types of targeted therapy drugs:
◉ Monoclonal antibodies – these are manufactured (synthetic) versions of immune system proteins called antibodies, which are part of the body’s natural defense against infections. The manufactured antibodies lock onto a protein on the surface of cells or surrounding tissues to interfere with the survival or growth of cancer cells.
◉ Small molecular inhibitors – drugs that can get inside cancer cells and block certain enzymes and proteins that tell cancer cells to grow.
⯐ How is targeted therapy given?
Targeted therapy drugs are usually prescribed by a hematologist or medical oncologist. They are generally given in repeating cycles with periods of rest in between. Targeted therapy drugs may be given on their own or in combination of chemotherapy drugs. Targeted therapy drugs They can be given as tablets that you swallow, through a drip into a vein in your arm or as an injection under your skin.
Some may be taken daily for months or even years – this will depend on the aim of treatment, how the cancer responds and any side effects you may have.
⯐ Will targeted therapy work?
Targeted therapy drugs will only work if the cancer contains the particular molecular target. Even if the cancer does contain the target, there is no guarantee the drug will kill the cancer cells. The response to targeted therapy varies depending on the cancer type and the molecular target. In some cancers, four out of five people considered suitable for a certain targeted therapy drug will respond.
⯐ What are the possible side effects of targeted therapy?
Targeted therapy aims to minimize harm to healthy cells but it can still have side effects. These will vary for each person depending on which drug you are taking and how your body responds. Some of the side effects from targeted therapy can include:
◉ Skin problems such as redness, sensitivity to light, a rash or swelling and dry flaky skin
◉ Itchy eyes with our without blurred vision
◉ Fatigue
◉ Headaches
◉ Joint aches
◉ Fever
◉ Nausea
◉ Diarrhea
◉ High blood pressure.
Less commonly, some targeted therapy drugs may affect the way the heart, liver or thyroid works.
Most side effects are temporary, lasting from a few weeks to a few months and will gradually improve over time or after you stop taking the medication. You may experience several side effects or none at all. Discuss ways to manage any side effects you may be experiencing with your treatment team.
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