Other treatments

Chemotherapy

Chemotherapy is the treatment of cancer using anti-cancer (cytotoxic) drugs. The aim is to destroy cancer cells while doing as little harm as possible to normal cells. Usually, treatment is given in cycles, spread over weeks or months. Chemotherapy is given by injection or drip into a vein, or via a portable infusion pump worn on the body to deliver the drugs continuously into the veins. Some chemotherapy drugs are given as tablets or capsules. Chemotherapy is usually given as an outpatient.

For more information, ask for the Chemotherapy/Hahau booklet at your local Cancer Society or call the Cancer Information Helpline 0800 CANCER (226 237) for a copy. 

“I used numbers. I had 30 days of chemo treatment. I used it like a football score. It was 1.29 tomorrow, then it was 2.28, 3.27, and as I got over half way I started to come right.” Reg

Side effects of chemotherapy

Side effects are usually temporary and go away soon after treatment. People may manage to continue with their normal life at home and work throughout their chemotherapy.

Problems may include:

• infections — the drugs can lower your ability to fight infections
• sore mouth
• diarrhoea (This may be severe; contact your treatment team immediately.)
• constipation
• feeling sick or vomiting
• tiredness
• loss of appetite or taste changes
• weight loss
• redness, numbness, pain and peeling of hands or feet (sometimes called hand and foot syndrome)
• hair loss is an uncommon problem for people being treated for bowel cancer
• women may find their periods become less regular or stop altogether
• hot flushes, a dry vagina, mood swings or other symptoms of menopause
• vaginal itch, burning or infections.

You and your partner should use a contraceptive during treatment because the drugs can cause birth defects or miscarriage.

If fever develops (if your temperature is 38 degrees or over) or you feel unwell, even with a normal temperature, don’t wait to see what happens — take action quickly. Contact your cancer doctor or nurse and follow the advice given

Radiation treatment

Radiation treatment is the use of high-energy radiation to destroy cancer cells or prevent them from reproducing. Radiation treatment only affects the part of the body at which the beam(s) is aimed, so is very localised.

Radiation treatment is commonly used in rectal cancer. It is given most commonly before the operation to shrink the cancer so that the surgeon can remove it more easily. Less commonly, it is given after surgery to destroy any remaining cancer cells. Radiation is usually given daily for five days a week. It can continue for six to seven weeks, depending on the size of the tumour, the kind of treatment being used and the dose required. Blood tests and scans may be needed, and you will see your doctor once a week.

For more information, ask for the booklet Radiation Treatment/Haumanu Iraruke at your local Cancer Society or phone the Cancer Information Helpline 0800 CANCER (226 237) for a copy.

“It’s like an X-ray machine. No worries. You’ve got a comfortable room, music going, then it’s over.” Milly

Side effects of radiation treatment

Although radiation treatment is not painful, there are side effects. Usually these are temporary. It is important to discuss any side effects with your cancer treatment team, who can advise you on how to manage these effects.

Side effects may include:

• tiredness
• diarrhoea
• skin irritation
• not wanting to eat
• nausea or vomiting
• loss of pubic hair
• pre-menopausal women who are treated in the pelvic or abdominal area may find their ovaries are affected. Because of the difficulty of shielding ovaries from radiation, pre-menopausal women may find their periods stop during treatment or for a few months afterwards, and may not return. They may also have hot flushes, a dry vagina or other symptoms of menopause. Menopausal symptoms can be controlled. If a woman’s ovaries are permanently affected, she will no longer be able to conceive children naturally
• men who are treated in the pelvic or abdominal area are less likely to have sexual problems because it is much easier to shield the testicles from radiation.

Chemo-radiation (chemotherapy and radiation treatment together) before surgery for rectal cancer

Research has shown that for people at greater risk of rectal cancer recurrence, the combination of chemotherapy and radiation treatment before surgery is more effective at reducing the risk of cancer coming back compared with radiation treatment alone. This treatment would be for a five-week period, usually followed by a six-week break while the radiation treatment continues to work. After this break, surgery would take place. However, having chemotherapy and radiation treatment together increases the chance and severity of side effects, such as diarrhoea, feeling sick (nausea) and low blood counts.

Treatment for advanced cancer

If the cancer has spread, your doctor will discuss various treatments for specific problems caused by the cancer.

These may include:

• surgery to remove the cancer or to bypass any obstruction so that the bowel will continue to work normally
• surgery to remove the cancer in other parts of the body, such as the liver or lungs
• chemotherapy and radiation treatment which can shrink the cancer and control symptoms, such as pain and bleeding
• treatment with monoclonal antibodies (called this because they come from a single cell), which work by recognising the protein on the surface of the cancer cell and then locking onto it (like a key in a lock). They destroy the cancer by either:An example of a monoclonal antibody is bevacizumab (Avastin).
  • triggering the body’s immune system to attack the cancer cell, causing the cell to kill itself, or
  • attaching a cancer drug or a radioactive substance to the antibody. This delivers them directly to the cancer cell because they target those specific cells (targeted therapy).
• ablation therapy, which includes radio frequency or alcohol ablation and cryotherapy (freezing treatment) for areas of cancer in the liver
• stenting to relieve bowel obstruction
• nerve blocks for pain.

Referral to palliative care services will be helpful for ongoing management and support. Contact your local Cancer Society for details of services within your area. In some cases, advanced cancer does not require immediate active treatment, especially if it is growing slowly.

For more information on advanced cancer, read the Cancer Society’s booklet Advanced Cancer/MatepukupukuMaukaha on the Society’s website or phone the Cancer Information Helpline 0800 CANCER (226 237) to receive a copy.