Common cancer treatments

Surgery, when used to treat cancer, is a procedure in which a surgeon removes cancer from your body. Depending on the type of cancer and how advanced it is, surgery may be used to remove the entire tumor, remove part of a tumor, or remove a tumor to help ease symptoms caused by cancer. Surgeons are medical doctors with special training in surgery. There are many types of surgery. Surgery may be open or minimally invasive.

• In open surgery, the surgeon makes one large cut to remove the tumor, some healthy tissue, and maybe some nearby lymph nodes.
• In minimally invasive surgery, the surgeon makes a few small cuts instead of one large one. She inserts a long, thin tube with a tiny camera into one of the small cuts. This tube is called a laparoscope. The camera projects images from the inside of the body onto a monitor, which allows the surgeon to see what she is doing. She uses special surgery tools that are inserted through the other small cuts to remove the tumor and some healthy tissue.

Because minimally invasive surgery requires smaller cuts, it takes less time to recover from than open surgery.

        
Why are you recommending surgery?
What are the benefits and risks of this type of surgery?
How long will recovery take?
Will other treatments be paired with surgery?    

Chemotherapy (also called chemo) is a type of cancer treatment that uses drugs to kill cancer cells. Chemotherapy works by stopping or slowing the growth of cancer cells, which grow and divide quickly. Chemotherapy not only kills fast-growing cancer cells, but also kills or slows the growth of healthy cells that grow and divide quickly. Examples are cells that line your mouth and intestines and those that cause your hair to grow. Damage to healthy cells may cause side effects, such as mouth sores, nausea, and hair loss. Side effects often get better or go away after you have finished chemotherapy.

Chemotherapy may be given in many ways. Some common ways include:

• Oral: The chemotherapy comes in pills, capsules, or liquids that you swallow.
• Intravenous (IV): The chemotherapy goes directly into a vein.
• Injection: The chemotherapy is given by a shot in a muscle in your arm, thigh, or hip, or right under the skin in the fatty part of your arm, leg, or belly.
• Intrathecal: The chemotherapy is injected into the space between the layers of tissue that cover the brain and spinal cord.
• Intraperitoneal (IP): The chemotherapy goes directly into the peritoneal cavity, which is the area in your body that contains organs such as your intestines, stomach, and liver.
• Intra-arterial (IA): The chemotherapy is injected directly into the artery that leads to the cancer.
• Topical: The chemotherapy comes in a cream that you rub onto your skin.

        
Why are you recommending chemotherapy?
What are the benefits and risks of chemotherapy?
How will the medicines be given to me?
Where do I go for chemotherapy?    

Radiation therapy (also called radiotherapy) is a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors. Radiation therapy can be used to treat cancer or help reduce symptoms when a cure isn’t possible. At low doses, radiation is used as an x-ray to see inside your body and take pictures, such as x-rays of your teeth and broken bones.

Radiation therapy can be external beam or internal:

• External beam radiation therapy comes from a machine that aims radiation at your cancer. The machine is large and may be noisy. It does not touch you, but it can move around you, sending radiation to your body from many directions.
• Internal radiation therapy is a form of treatment in which a source of radiation is put inside your body. One form of internal radiation therapy is called brachytherapy. In brachytherapy, a solid radiation source, such as seeds, ribbons, or capsules, is placed in your body in or near the cancer. Internal radiation can also be in liquid form. You receive liquid radiation by drinking it, swallowing a pill, or getting it through an IV line. Liquid radiation travels throughout your body, seeking out and killing cancer cells.

        
Why are you recommending radiation therapy?
What are the benefits and risks of radiation therapy?
How many weeks will my course of radiation therapy last?
What kind of radiation therapy will I receive?    

Immunotherapy is a type of cancer treatment that helps your immune system fight cancer. The immune system helps your body fight infections and other diseases. It is made up of white blood cells and organs and tissues of the lymph system.

Several types of immunotherapy are used to treat cancer. These include:

• Immune checkpoint inhibitors, which are drugs that block immune checkpoints. These checkpoints are a normal part of the immune system and keep immune responses from being too strong. By blocking them, these drugs allow immune cells to respond more strongly to cancer.
• T-cell transfer therapy, which is a treatment that boosts the natural ability of your T cells to fight cancer. In this treatment, immune cells are taken from your tumor. Those that are most active against your cancer are selected or changed in the lab to better attack your cancer cells, grown in large batches, and put back into your body through a needle in a vein. T-cell transfer therapy may also be called adoptive cell therapy, adoptive immunotherapy, or immune cell therapy.
• Monoclonal antibodies, which are immune system proteins created in the lab that are designed to bind to specific targets on cancer cells. Some monoclonal antibodies mark cancer cells so that they will be better seen and destroyed by the immune system. Such monoclonal antibodies are a type of immunotherapy. Monoclonal antibodies may also be called therapeutic antibodies.
• Treatment vaccines, which work against cancer by boosting your immune system’s response to cancer cells. Treatment vaccines are different from the ones that help prevent disease.
• Immune system modulators, which enhance the body’s immune response against cancer. Some of these agents affect specific parts of the immune system, whereas others affect the immune system in a more general way.

        
Why are you recommending immunotherapy?
What are the benefits and risks of immunotherapy?
Do I need any tests before receiving immunotherapy?
Can immunotherapy be combined with other treatments?    

Targeted cancer therapies are drugs or other substances that block the growth and spread of cancer by interfering with specific molecules (“molecular targets”) that are involved in the growth, progression, and spread of cancer. Targeted cancer therapies are sometimes called “molecularly targeted drugs,” “molecularly targeted therapies,” “precision medicines,” or similar names.

        
Why are you recommending targeted therapy?
What are the benefits and risks of targeted therapy?
Is targeted therapy the same as chemotherapy?
What types of targeted therapies are available?    

Hormone therapy is a cancer treatment that slows or stops the growth of cancer that uses hormones to grow. Hormone therapy is also called hormonal therapy, hormone treatment, or endocrine therapy.

Hormone therapy may be given in many ways. Some common ways include:

• Oral – Hormone therapy comes in a pill that you swallow.
• Injection – The hormone therapy is given by a shot in the muscle in your arm, thigh, or hip or right under the skin in the fatty part of your arm, leg, or belly.
• Surgery – You may have surgery to remove organs that produce hormones. In women, the ovaries are removed. In men, the testicles are removed.

        
Why are you recommending hormone therapy?
What kind of hormone therapy are you recommending?
What are the benefits and risks of hormone therapy?
How should I take my hormones?    

Stem cell transplants are procedures that restore blood-forming stem cells in people who have had theirs destroyed by the very high doses of chemotherapy or radiation therapy that are used to treat certain cancers. Stem cell transplants are most often used to help people with leukemia and lymphoma. They may also be used for neuroblastoma and multiple myeloma. Stem cell transplants do not usually work against cancer directly. Instead, they help you recover your ability to produce stem cells after treatment with very high doses of radiation therapy, chemotherapy, or both.

Types of stem cell transplants:

• Autologous, which means the stem cells come from you, the patient.
• Allogeneic, which means the stem cells come from someone else. The donor may be a blood relative but can also be someone who is not related.
• Syngeneic, which means the stem cells come from your identical twin, if you have one.

        
Why are you recommending a stem cell transplant?
What are the benefits and risks associated with a stem cell transplant?
Will there be a donor for me?
How long will the stem cell transplant take?