“The 3 main cancer treatments are surgery, radiation therapy and chemotherapy. Other types of treatments, such as hormonal therapy, biological therapy or stem cell transplant, may also be used in certain cases for some types of cancer. Cancer treatment is given by cancer specialists (oncologists). Some specialize in surgery, some in radiation therapy and others in chemotherapy (drugs). These doctors work with the person with cancer to decide on a treatment plan. People with cancer are given individual treatment plans based on their: type of cancer cancer’s characteristics stage of cancer personal situation and wishes Sometimes, 2 people with the same cancer may be given very different treatments.” Read more: http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/treatment/?region=bc#ixzz2dO9zOavZ What is Chemotherapy Radiation Surgery Photodynamic Therapy (PDT) Stem cell transplant Hormonal therapy
Chemotherapy: My Experience
When they told me I would have 6 big chemo treatments and 11 adjacent chemo’s to go through, I was scared. Chemotherapy is a powerful word and having to imagine myself going through it every three weeks was something that I couldn’t seem to prepare myself for. Although there are well known side effects from chemo (loss of hair, vomiting, fatigue), everyone has a different experience and the stories I was hearing or reading about scared me. This is my experience of how I reacted to chemotherapy and while it may not be identical to yours, I hope that some of the questions surrounding the chemo experience can be answered.
The first session took more than 6 hours because we had to wait for 30 minutes to an hour to see how my body was reacting to the drug and if i was having any kind of adverse reaction especially to the pertuzamab (which is the drug that I was on for the study). Some chemo’s required a pill to be taken before you start or a very icy glove to be put on. The icy glove is recommended because it helps prevent the drugs going into your extremities in your hand and helps prevent losing your fingernails. The next 5 chemo sessions went much better, it only took between 4 to 5 hours.
I was afraid of the side effects from chemotherapy. You hear all the horror stories about the pain and that the chemo was harder to go through than the actual cancer. I had an aunt who died from Leukemia and I remembered all the pain she went through. Scenes from the movie “Love Story” were on constant replay in my head. I decided that I need to dig deep for my courage and take it one chemo at a time. I had a 50/50 chance of success so I had nothing to lose. I took the risk. My Oncologist was very reassuring, telling me that every year the treatments were getting better and better and the side effects were getting less intense. Because I was getting more than 4 chemo’s, I was given the option of having a Port (or portacath) ” It is a small medical appliance that is installed beneath the skin. A catheter connects the port to a vein. Under the skin, the port has a septum through which drugs can be injected and blood samples can be drawn many times, usually with less discomfort for the patient than a more typical “needle stick”. Ports are used mostly to treat hematology and oncology patients, but recently ports have been adapted also for hemodialysis patients. The port is usually inserted in the upper chest, just below the clavicle or collarbone, leaving the patient’s hands free. “ From Wikipedia How a Portacath is used for Chemotherapy Treatment see video http://www.youtube.com/watch?v=FiDQAfF2TKc http://www.youtube.com/watch?v=vszY9i-sWzQ http://www.youtube.com/watch?v=wkSpnFf1caE
It took only an hour, with a local anesthesia, to put in the port. I didn’t feel anything, only a sore neck for two days. This might not work for everyone but after I had the port and went to my next chemo session, it was hard to see other people getting the “needle stick”. Some patients veins were getting smaller after each chemo so it was getting more difficult to stick the needle in their vein. Although the port wasn’t “fun” there was noticeably less discomfort then when I had the needle. If you have difficulty with needles or already are dreading the whole process, I highly recommend the port or at least try it. By the time I was at the last two chemo’s and after having my blood taken every week, needles had become unbearable. If I didn’t have the port I can only imagine how more horrible doing chemo would have been. Everyone needs to pick the best methods that work for them and I believe that anything that gives you ease and less suffering, is something that should be tried.
After the chemo they give you a special pill to prevent vomiting. It worked very well for me, I didn’t throw up once but I did have intense diarrhea. I also developed hemorrhoids. For that my Oncologist recommended, cleaning every time with this small pad call TUCKS made by the same company as anusol or just water and soap; and use a suppository “ANUSOL PLUS”. That helped a lot. I didn’t need a prescription for it, you can find it at any pharmacy or drug store. If they don’t have it, ask you pharmacist to order it for you. I suffered three days of constipation after my first chemo and I took SANOKOT. 4 days after the chemo I was starting to feel weird, more tired than usual so I was sleeping more. I was drinking a lot of water 8-10 glass a day especially before meals. On the 7th day food started changing. The smell of it was intense, everything smelled so delicious! But when I put it in my mouth it was like eating sand, especially chicken. I was eating a lot of soup and smoothies. Digestion is harder so they recommend having some TUMS in hand. By the time the 10th day came around I started to feel a bit better and then a couple of days later I was back in chemo and the cycle started all over again.
I was doing everything my Oncologist was telling me to do. Physically I was pushing my body to its limits to fight. Chemo was wiping me out physically, my hair was falling out, I was tired and I had no control over any bodily functions. My body was suffering but I decided I didn’t want to anymore. I needed to be strong mentally so I pushed myself to go outside every day for 30 minutes to an hour to take a walk and get some fresh air. Not only did it clear my mind and give me a feeling of some control back but it also helped build up my immune system. I was incredibly tired and the urge to just lie in bed or in my lounger was strong but I knew that I needed to stay as active as I could. Take care of yourself in whatever way you need. Sleep, read, do nothing to exhaust yourself. Think only positive thoughts of getting better, ask for help when you need to. Go outside if you can because even walking in the rain is beautiful.
What I recommend is:
If you can have a port do it!
Have TUMS for your heartburn ANUSOL PLUS suppository for your hemorrhoids.
A blender to blend your food, if you are suffering from diarrhea, eat more yogurt to restore your intestinal flora; and if you cannot eat yogurt take a probiotic. I used Flora brand UDO’s CHOICE probiotic super 8 plus (Canadian company in BC). It worked well for me but they have other brands at your local natural store and pharmacy.
You are losing a lot of water when you have diarrhea or vomiting. And you are losing your electrolytes. Electrolytes are necessary for many functions in the body, especially for your heart. Muscle loss weakens you, and reduces your metabolism. Drink a lot of water. A homemade simple electrolyte drink can be made by using the correct proportions of water, sugar, salt, salt substitute for potassium and baking soda. Electrolytes are commonly found in fruit juices,coconut water, sports drinks, milk, and many fruits and vegetables (whole or in juice form). Or you can buy electrolyte drinks containing sodium and potassium salts like SPORT DRINKS.
If you are constipated, SENOKOT is a natural source laxative and it’s comes as a syrup or in pills.
Six weeks after my surgery, on September 15, 2010, I started the radiation. I went to BCCA and they showed me a video of the procedure I would have to go through. They made a mould of my head, my shoulder and my left arm; that way, every time I went for my radiation, I would put myself in that mould and be in the exact same place. They also did a few tattoo points on my body, to align the laser.
I didn’t find the radiation that bad. I felt nothing during the treatment; I only noticed that my skin became red after the treatment. Morning and night, I applied a cream called Glaxal Base Moisturizing Cream or Lotion. It’s what Dr. Weir, the oncologist for the radiation, suggested. It’s a water based cream and nurses use it too. Dr. Weir explained everything meticulously. I was scared to start the radiation, but she was able to answer all my questions and put my fears to rest. Because the radiation was going in a small portion of my neck, for a few months, I had to be careful when I was swallowing food, especially my pills. I choked on them at least a dozen times. I had to cut them into small pieces to be on a safe side. Again you need to rest, radiation cause fatigue, because your body is healing. so have a lot of sleep.
I had a bilateral mastectomy on July 30, 2010. The surgery took 4 hours. My oncologist specializing in surgery, Dr. Noel Davis, did the first part of the operation, removing my breast and the nodules under my armpit. They removed 20 nodules. That means I’m at risk for life for Lymphodemia in my left arm but am cancer free so far.
The pathology tests of the two tumors came back negative. The cancer was gone completely. It’s unbelievable what that new drug did for me. Even my doctors were amazed by the results. They said it’s because of the new drug; I say it’s a miracle. I was at stage 3+ which is one of the worst stages to be diagnosed at.
After that, Dr. McAdams started the reconstruction of my right breast with an alloderm and the implant. She also installed a tissue expander in my left breast; that way they can do the radiation safely. The operation was tough. For 2 weeks I was unable to get up from my bed by myself or wash myself. This is where my organization beforehand truly proved itself. I had my mom and all the right tools to help me, the hand shower, a bench.
I had my other big surgery on June 30,2011 to finish the reconstruction and I had 5 small local anesthetic surgeries. Surgery for me was one of my hardest times. The recovery is slow and painful and it takes every bit of energy just to keep going. Again I am extremely grateful for all the help that surrounded me. That is the best advice I can give for this part. Ask for help.
Chemotherapy is given with a curative intent or to prolong life or to palliate symptoms. Usually, chemotherapy will be combining with other cancer treatments, such as radiation therapy or surgery. Chemotherapy is the treatment of cancer by killing micro organisms or cancerous cells. Chemotherapy acts by killing cells that divide rapidly, which are the main properties of most cancer cells. When cells divide they split into two, identical new cells. So, where there was 1 cell, there are now 2 and 4 and then 8 and so on. In cancer the cells keep on dividing until there is a mass of cells. This mass of cells becomes a lump. The lump is called a tumour. Cancer cells divide much more often and faster than most normal cells.
The main ways you can have chemotherapy are as
- An injection into the bloodstream (usually through a vein)
- A drip (intravenous infusion) into the bloodstream through a vein
Combination chemotherapy You may have a combination of different chemotherapy drugs. The combination will include chemotherapy drugs that damage cells at different stages in the process of cell division. And with more than one type of drug, there is more chance of killing more cells. The biggest advantage is minimizing the chances of resistance developing to any micro-organisms or cancerous cells. The drugs differ for each patient and side effects talk to your Oncologist. A lot of Factors has to be taking in consideration. The type of patient (age, weight, health etc.), the type of cancer, the stage of cancer, the type of chemotherapy, and the dosage. You may get treatment every day, every week or every month. You may have breaks between treatments so that your body has a chance to build new healthy cells. You might take the drugs by mouth, in a shot or intravenously. For prolonged intravenous chemotherapy administration, various systems may be surgically inserted into the vasculature to maintain access. Commonly used systems are the Hickman line, the Port-a-Cath or the PICC line. How. Chemotherapy enters the bloodstream and damages dividing cells. Cells in the process of dividing are more at risk of being killed by chemotherapy. Chemotherapy kills the cell by damaging the part of the control centre inside each cell that makes cells divide. Or it may interrupt the chemical processes involved in cell division. Only a fraction of the cells in a tumor die with each treatment, repeated doses must be administered to continue to reduce the size of the tumor. Current chemotherapy regimens apply drug treatment in cycles, with the frequency and duration of treatments adapted to each patient. All chemotherapy requires that the patient be capable of undergoing the treatment. Blood test is often used between cycle to determine whether a patient can receive chemotherapy, or if a change in dose reduction. neoadjuvant chemotherapy (preoperative treatment) initial chemotherapy is designed to shrink the primary tumour, thereby rendering local therapy (surgery or radiotherapy) less destructive or more effective. Adjuvant chemotherapy (postoperative treatment) can be used when there is little evidence of cancer present, but there is risk of recurrence. This can help reduce chances of developing resistance if the tumor does develop. It is also useful in killing any cancerous cells, which have spread to other parts of the body. This is often effective as the newly growing tumors are fast dividing, and therefore very susceptible. Palliative chemotherapy is given without curative intent, but simply to decrease tumor load and increase life expectancy. For these regimens, a better toxicity profile is generally expected. The most common side effects of chemotherapy: During chemotherapy you may have no side effects or just a few. The kinds of side effects you have depend on the type and dose of chemotherapy you get. Side effects vary, but most common ones are: Decreased production of blood cells Nausea and vomiting, (inflammation of the lining of the digestive tract), Tiredness Pain Hair loss (Alopecia) Healthy cells usually recover after chemotherapy, so most side effects gradually go away and take time, be patient with yourself. Other side effect, which may append: depending of your chemotherapy. Anemia Appetite Changes Bleeding Problems Constipation Diarrhea Fatigue (Feeling weak and very tired) Infection Memory Changes Mouth and Throat Changes Nerve Changes Sexual and Fertility Changes in Men Sexual and Fertility Changes in Women Skin and Nail Changes Swelling (Fluid retention) Urination Changes “You cannot tell if chemotherapy is working based on its side effects. Some people think that severe side effects mean that chemotherapy is working well. Or that no side effects mean that chemotherapy is not working. The truth is that side effects have nothing to do with how well chemotherapy is fighting your cancer.” From: http://www.medicinenet.com/chemotherapy/page5.htm
Chemotherapy and other drug therapies
Drug therapies work in different ways to destroy cancer cells, stop them from spreading or slow down their growth. Drugs may also be used to lessen, or relieve, side effects of cancer or its treatment. Chemotherapy (sometimes called chemo) destroys cancer cells or slows down how fast they grow. Some chemotherapy drugs are given on their own. More often, several chemotherapy drugs are used together to destroy cancer cells. Hormonal drug therapy changes the levels of certain hormones in your body to destroy cancer cells or slow down how fast they grow. Biological therapy helps make your body’s immune system stronger so it can destroy cancer cells and stop cancer from coming back. Targeted therapy uses drugs to target specific molecules (for examples, proteins) in cancer cells to stop them from growing and spreading. Targeting cancer cells means that these drugs don’t damage as many normal cells. Supportive drugs prevent, manage or relieve side effects that cancer or cancer treatments may cause. For example, bisphosphonates help strengthen bones and protect them against the effects of some cancers and their treatments. Sometimes drug therapy is the only treatment you receive. You may need only one type of drug therapy, or you may receive a combination of drug therapies. For example, biological therapy may be given with chemotherapy to help lessen side effects and make the immune system stronger. Goals of drug therapy Your doctor will explain the goals of your treatment plan. As part of your treatment plan, drug therapy may be used in the following ways. Drug therapy may cure the cancer by destroying all the cancer cells and reducing the chances that the cancer will come back. It can control the cancer by stopping cancer cells from growing and spreading or destroying cancer cells that have spread to other parts of the body. Drugs can prevent the growth or spread of new cancer cells. They can relieve the symptoms of the cancer and help you feel more comfortable when curing the cancer is not possible.
Drug therapy and other treatments
Drug therapy may be used as the first-line therapy (the primary, most common or preferred treatment). It may also be used with other treatments as part of your treatment plan. Drug therapies may be used as adjuvant therapy. This means that drug therapies are given in addition to the first-line therapy. The drugs destroy any cancer cells that are still in the body after surgery or radiation therapy and help reduce the risk that the cancer will come back (recur). Sometimes drugs are given as neoadjuvant therapy. They are used to shrink a tumour before the first-line therapy. Shrinking the tumour makes it easier to remove with surgery or to treat with radiation. Drug therapy given at the same time as other treatments is called concurrent therapy. For example, certain chemotherapy drugs may be given at the same time as radiation therapy to make cancer cells more sensitive to radiation. from: http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/chemotherapy-and-other-drug-therapies/?region=bc
How well chemotherapy works
“Some of cancers which, had chemotherapy works very well, like the testicular cancer and Hodgkin’s lymphoma. But the chemotherapy curing your cancer depends on the type of cancer you have and how you respond to it. With some types of cancer most people are cured by chemotherapy, With other types of cancer fewer people are completely cured With some cancers, chemotherapy can’t cure the cancer on its own. But it can help in combination with other types of treatment. For example, many people with breast or bowel cancer have chemotherapy after surgery to help lower the risk of the cancer coming back. With some cancers, if a cure is unlikely, your doctor may still suggest chemotherapy to
- Shrink the cancer
- Relieve your symptoms
- Give you a longer life by controlling the cancer or putting it into remission”
What remission means
Remission, it’s a period during which symptoms of disease are reduced when talking about cancer (partial remission) or disappear (complete remission). Remission means that after treatment there is no sign of it on scans or when the doctor examines you. They cannot be sure that there are no cancer cells in the body. So the cancer could come back in the future, although there is no sign of it at the time. It why in breast cancer we have to take special pills like tamoxafine or anti-hormonal to continues to fight this cells, usually between 3 to 5 years. “The tumour-free time period, and is dated from the first, not the last, therapy session. Patients with tumors that recur within one month of treatment ending are considered to have had no remission. Disappearance of all disease is complete remission; reduction tumour size by more than 50 percent is considered partial remission.” From: http://www.patientcenters.com/lymphoma/news/nhl7.html “Remission is not a cure. When discussing breast cancer, it is important to understand the difference between being cured versus being in remission. However, a patient in complete remission is living a life that is cancer free. Partial remission is defined as the lack of presence of a large percentage of the signs and symptoms of breast cancer, but some may still remain. Complete remission, on the other hand, is when there is no presence of cancer apparent in the body. Even in complete remission, there is still a chance the cancer can come back which is why a patient in remission is not considered to be cured. When discussing remission, doctors will often refer to the five-year cure rate. In some cases they may even discuss a 10 (or more) year cure rate. This simply means that a woman has been in full remission, with no indication of recurrence for five years or more. The five-year cure rate does not mean that the cancer will not come back. In fact, in some rare cases it may recur even after many years of remission. What it does mean, however, is that the risk of recurrence is quite low and that a woman is able to live cancer free for many years and potentially for the rest of her life.” From: http://breastcancer.answers.com/resources/breast-cancer-and-remission-what-does-it-mean
Types of cancer remission.
Complete remission means that the cancer cannot be detected on scans, X-rays, or blood tests, etc. Doctors sometimes call this a complete response. Partial remission means the treatment has killed some of the cells, but not all. The cancer has shrunk, but can still be seen on scans and doesn’t appear to be growing. The treatment may have stopped the cancer from growing. Or the treatment may have made the cancer smaller so that other treatments are more likely to help, such as surgery or radiotherapy. This is sometimes called a partial response. Stable disease, This can mean that the cancer has stayed the same size or it may even have grown by a small amount. Spontaneous remission, also called spontaneous healing or spontaneous regression, is an unexpected improvement or cure from a disease that appears to be progressing in its severity. These terms are commonly used for unexpected transient or final improvements in cancer. Spontaneous remissions concern cancers of the haematopoietic system (blood cancer, e.g. leukemia), while spontaneous regressions concern palpable tumors. From Wikipedia Remission does not mean that a cancer has been cured. There may still be cancer cells present that are undetectable by tests. Most of cancer will have pills to take for a few years after treatment trying to kill these cancer cells.
That means the cancer had returns after it has been in remission (few cancer cells remain which can later grow and present as a cancer recurrence). “If you are in remission, you need to take exceptional care of your body with frequent follow-up exams, healthy diet, and regular exercise. Many women live for years after breast cancer treatment, and understanding remission and the resources is crucial to battling breast cancer and helping survivors lived full, happy lives.” “One of the ways to reduce the risk of recurrence, or to catch any recurrent cancer quickly and treat it, is to see your doctor regularly. Frequent follow-up exams are important in order to catch any signs of cancer recurrence early on. In addition, patients in remission are encouraged to contact their doctors with any unusual pain or suspicious lumps in the breast as these can be indications of cancer recurrence.” From: http://breastcancer.answers.com/resources/breast-cancer-and-remission-what-does-it-mean Cancer Treatment Chemotherapy http://www.youtube.com/watch?v=11FMbqL_nGY Chemotherapy Part 1 http://www.youtube.com/watch?v=eJq4xvjd_MU Chemotherapy Part 2 http://www.youtube.com/watch?v=YzkAXSB3loM
Eat the Right Foods During Chemotherapy
Add protein to your diet. Protein can reduce the fatigue most chemotherapy patients experience. Eat lean meat and beef, beans and eggs and drink skim milk. Set an appointment with a nutritionist. A nutritionist can provide you with simple menus that offer all the nutrients and vitamins you need. In general, you should eat fruit, vegetables and bread, along with smaller quantities of lean meat and skim milk. Usually at your cancer center you can meet with a nutritionist who can help you. Limit your alcohol consumption. Drinking excessively puts stress on your liver, and it may interfere with the drugs the doctor employs in your chemotherapy treatments. Consider maintaining a diet rich in nutrients even after your therapy is complete. Filling your diet with foods rich in antioxidants and vitamins can help your body to fully recover. Eat soup or drink juice if your side effects prohibit you from eating solid food. Instant breakfasts and other liquid meal replacements also work well. Do not skip meals; your body needs nutrients.
Chemoembolization Extends Lives of Cancer Patients
Chemoembolization only treats tumors in the liver and will have little or no effect on any other cancer in the body. The following liver cancers may be treated by chemoembolization: hepatoma (primary liver cancer) metastasis (spread) to the liver from: colon cancer carcinoid ocular melanoma sarcomas a primary tumor in another part of the body “Chemoembolization is performed by placing a small catheter from the blood vessel in your groin into the artery that supplies blood to the liver. This is analogous to the more familiar cardiac angiogram. The chemotherapeutic drug(s) are then delivered through the catheter along with a blood vessel occluding agent right at the site of the tumor. The result is that a very highly concentrated dose of anti-tumoral drug is delivered (without the normal dilution that occurs with a standard intravenous infusion) and the blood vessels are partially blocked with the occluding agent to starve the tumor of it’s blood supply. This “double-punch” can slow or stop tumor growth, and in some cases can even result in significant shrinkage of the tumor.” From: http://www.hopkinsmedicine.org/vascular/procedures/chemoembolization/ http://www.youtube.com/watch?v=4WcuOGxrszc
“Radiation therapy uses high-energy radiation to kill cancer cells by damaging their DNA. Radiation therapy can damage normal cells as well as cancer cells. Therefore, treatment must be carefully planned to minimize side effects. The radiation used for cancer treatment may come from a machine outside the body, or it may come from radioactive material placed in the body near tumor cells or injected into the bloodstream. A patient may receive radiation therapy before, during, or after surgery, depending on the type of cancer being treated. Some patients receive radiation therapy alone, and some receive radiation therapy in combination with chemotherapy. “ See more: http://www.cancer.gov/cancertopics/factsheet/Therapy/radiation
“Radiation for cancer treatment uses higher doses of radiation to destroy cancer cells. Radiation therapy works by damaging the cancer cells over and over again. The cancer cells don’t have time to repair themselves in between daily treatments, so eventually they die. Normal cells can repair and replace themselves between these daily sessions of radiation therapy. Even though cancer cells and normal cells react differently to radiation, it’s very hard to destroy cancer cells without damaging some normal cells too. The goal of radiation therapy is to give enough radiation to destroy cancer cells in your body, but not so much that normal cells can’t recover.” Read more: http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/radiation-therapy/
Radition video: http://www.youtube.com/watch?v=_moypMx05Fw
Breast cancer video from http://www.youtube.com/watch?v=jj8z9xbb6Fk
Also called: photoradiation therapy phototherapy photochemotherapy Photodynamic therapy (PDT) destroys cancer cells by using a drug called a photosensitizer, which makes the cells sensitive to laser light. PDT is a fairly new procedure and was approved for use in Canada in the 1990s. It is used: *to treat tumours in the lining of some organs *to relieve blockages caused by tumours in the esophagus or lungs In the first step of PDT for cancer treatment, a photosensitizing agent is injected into the bloodstream. The agent is absorbed by cells all over the body but stays in cancer cells longer than it does in normal cells. Approximately 24 to 72 hours after injection 1), when most of the agent has left normal cells but remains in cancer cells, the tumor is exposed to light. The photosensitizer in the tumor absorbs the light and produces an active form of oxygen that destroys nearby cancer cells). In addition to directly killing cancer cells, PDT appears to shrink or destroy tumors in two other ways . The photosensitizer can damage blood vessels in the tumor, thereby preventing the cancer from receiving necessary nutrients. PDT also may activate the immune system to attack the tumor cells. The light used for PDT can come from a laser or other sources. Laser light can be directed through fiber optic cables (thin fibers that transmit light) to deliver light to areas inside the body . For example, a fiber optic cable can be inserted through an endoscope (a thin, lighted tube used to look at tissues inside the body) into the lungs or esophagus to treat cancer in these organs. Other light sources include light-emitting diodes (LEDs), which may be used for surface tumors, such as skin cancer . PDT is usually performed as an outpatient procedure. PDT may also be repeated and may be used with other therapies, such as surgery, radiation, or chemotherapy. A range of tests may be done before PDT, depending on the area being treated. Preparations similar to endoscopic procedures or conventional surgery may be needed. Side effects The photosensitizer makes the skin and eyes sensitive to strong indoor or outdoor light (photosensitive) for 4 to 6 weeks or more after treatment, so special precautions need to be taken. Photosensitizers tend to build up in tumors and the activating light is focused on the tumor. As a result, damage to healthy tissue is minimal. However, PDT can cause burns, swelling, pain, and scarring in nearby healthy tissue . Other side effects of PDT are related to the area that is treated. They can include coughing, trouble swallowing, stomach pain, painful breathing, or shortness of breath; these side effects are usually temporary. Extracorporeal photopheresis (ECP) is a type of PDT in which a machine is used to collect the patient’s blood cells, treat them outside the body with a photosensitizing agent, expose them to light, and then return them to the patient. The U.S. Food and Drug Administration (FDA) has approved ECP to help lessen the severity of skin symptoms of cutaneous T-cell lymphoma that has not responded to other therapies. Studies are under way to determine if ECP may have some application for other blood cancers, and also to help reduce rejection after transplants. PDT may be used with other cancer treatments such as surgery, chemotherapy or radiation therapy. Tumours that regrow and start to cause problems again can be retreated with PDT.
Stem cell transplant replaces a person’s blood-forming (hematopoietic) stem cells. It is used when stem cells or the bone marrow has been damaged by chemotherapy drugs, radiation therapy or disease (such as cancer). The new stem cells make healthy blood cells. Stem cells are young, immature cells. Stem cells mature (through a process called differentiation) to become different types of specialized cells. They can copy (replicate) themselves to replace or rebuild tissues in the body. Some stem cells mature into blood cells. Blood-forming stem cells develop into different types of blood cells in the bone marrow. When blood cells are mature, they move from the bone marrow into the bloodstream. Stem cell transplants use blood-forming stem cells from the bone marrow and blood circulating in the body (peripheral blood) in adults. They may also use blood-forming stem cells from the umbilical cord (the cord that supplies a developing fetus with blood and nutrients). Sometimes a stem cell transplant may be described by the source of the stem cells. Stem cell transplant is also called: bone marrow transplant blood cell transplant (BCT) peripheral blood stem cell transplant (PBSCT) hematopoietic stem cell transplant (HSCT) high-dose therapy with stem cell rescue There are 3 main types of stem cell transplants. They are described based on who donates the stem cells.
- Allogeneic transplants use stem cells taken from one person (donor) and given to another person (recipient). The donor may be a relative (usually a sibling) or a volunteer who isn’t related to the recipient.
- Syngeneic transplants are a type of allogeneic transplant. They use stem cells taken from one identical twin and given to the other twin.
- Autologous transplants use stem cells taken from the recipient’s own bone marrow or blood.
Stem cell transplant for children —>>>>>Read more: http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/stem-cell-transplant/?region=bc#ixzz2dOF5I4Rz
Treatment that adds, blocks, or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. To slow or stop the growth of certain cancers (such as prostate and breast cancer), synthetic hormones or other drugs may be given to block the body’s natural hormones. Sometimes surgery is needed to remove the gland that makes a certain hormone. Also called endocrine therapy, hormone therapy, and hormone treatment. Hormones are chemicals substances that regulate specific body functions, such as metabolism, growth and reproduction. They travel in the blood and control the activity or growth of certain cells. For example, the hormones estrogen and testosterone control the growth, development and function of female and male reproductive organs. Some cancer cells need hormones to grow. For example, some breast cancer cells need estrogen to grow. Cancer cells that need hormones to grow are called hormone dependent. Drugs, surgery or radiation therapy to specific organs can be used to change hormone levels. Hormonal therapy affects hormone levels throughout the body, so it is considered a systemic therapy. Hormone therapy is another form of systemic therapy. It is most often used as an adjuvant therapy to help reduce the risk of the cancer coming back after surgery, but it can be used as neoadjuvant treatment, as well. It is also used to treat cancer that has come back after treatment or has spread. Estrogen promotes the growth of about 2 out of 3 of breast cancers— those having receptors for the hormones estrogen (ER-positive cancers) and/or progesterone (PR-positive cancers). Because of this, several approaches to blocking the effect of estrogen or lowering estrogen levels are used to treat hormone receptor-positive breast cancers. Hormone therapy does not help patients whose tumors are both ER- and PR-negative. see more: http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-treating-hormone-therapy
Glands and organs that produce hormones
- estrogen and progesterone – female hormones involved in reproduction
testicles (testes) small reproductive organs in the scrotum (the loose skin sac at the base of the penis) Hormone produced
- testosterone – male hormone involved in reproduction
pituitary gland small gland at the base of the brain. Hormone produced
- luteinizing hormone (LH) – stimulates the testicles and ovaries
- adrenocorticotropic hormone (ACTH) – stimulates the adrenal glands
- follicle-stimulating hormone (FSH) – stimulates the ovaries and testicles
- thyroid-stimulating hormone (TSH) – stimulates the thyroid gland
Adrenal glands small glands above the kidneys Hormone produced
- corticosteroids (steroids) – lower the body’s immune responsemineralocorticoids (for example, aldosterone) – help maintain water and electrolyte balance in the body
- estrogen (in post-menopausal women)
- testosterone (in small amounts) – involved in reproduction
Pancreas gland located behind and below the stomach Hormone produced
- glucagon – raises blood sugar level
- insulin – lowers blood sugar lev
Hormonal therapy is also called:
- hormone withdrawal therapy
- hormone manipulation
- endocrine therapy
Natural hormones are produced by glands or organs in the body. Artificial or synthetic hormones can be made in a lab. Hormone treatment Changing hormone levels in the body can affect cancer cells that are hormone dependent. There are 3 ways to change hormone levels:
- remove the gland or organ that makes the hormone
- treat the gland or organ with radiation to destroy hormone-producing cells
- take hormones or other drugs that interfere with or stop the production of the hormone
Hormone-dependent cancer cells have receptors on their surfaces. Receptors are sites where the hormones attach to the cells and tell them to grow. Certain drugs can block the hormone receptors on the surface of cancer cells. The use of drugs to control or block hormones is called hormonal drug therapy. Sometimes a sample of the tumour is tested to find out:
- the type of hormone receptor on the surface of the cancer cells
- the amount of receptor (hormone receptor level)
- if hormonal therapy is likely to be effective
Generally, the higher the hormone receptor level (positive test), the more responsive the tumour will be to hormonal drug therapy. If there are no receptors or very few receptors on the cancer cells (negative test), hormones will probably not affect cancer cell growth and other cancer therapies may be more effective. Breast cancer tumours are most commonly tested for estrogen (ER) and progesterone (PR) receptors. Although there are tests for other receptors involved in other types of cancer, measuring them is not part of current practice. Hormonal therapy and other treatments Hormonal therapy may be used as the first-line therapy (the primary, most common or preferred treatment). It may also be used with other treatments as part of your treatment plan.
- Hormonal therapy may be used as neoadjuvant therapy. It is given before surgery to shrink the tumour and make it easier to remove. It may also be given before radiation therapy to shrink the tumour so radiation is given to a smaller area.
- Sometimes hormonal therapy is used as adjuvant therapy. It is given in addition to the primary treatment (such as surgery or radiation therapy) to more effectively treat the cancer and to lower the risk that the cancer will recur (come back).
The side effects of hormonal therapy depend on the type of hormonal therapy used.
Potential side effects of hormonal therapy
Side effects can occur with any type of treatment, but not everyone has them or experiences them in the same way. Side effects of hormonal therapy will depend mainly on:
- The type of hormonal therapy used
- The dose of hormonal drug therapy
- The person’s overall health
Different hormonal therapies cause different side effects. Only the main side effects are covered here. Side effects can happen any time during treatment. Some may happen during, immediately after or a few days or weeks after treatment. Sometimes side effects improve as the body adjusts to hormonal therapy. Most side effects go away when the hormonal therapy drug is stopped, depending on how long it was taken and other factors. However, some side effects may persist after treatment is completed. Late side effects can occur months or years after treatment. Some side effects may last a long time or be permanent. It is important to report side effects to the healthcare team. Doctors may grade (measure) how severe certain side effects are. Sometimes hormonal therapy may need to be adjusted if side effects are severe. Nausea and vomiting Nausea and vomiting can occur with some hormonal therapy drugs. This usually gets better as the body gets used to the drug, or it can improve on its own. Taking hormonal therapy drugs with food or at bedtime may help. Nausea and vomiting occurring with radiation therapy to the abdomen can occur a few hours after the radiation treatment. Check with the doctor or healthcare team if nausea or vomiting persists. Swelling or weight gain Swelling of the hands or feet is sometimes caused by fluid retention. Some hormonal therapy drugs can cause weight gain. Weight gain may be controlled by diet and exercise. Check with the doctor or healthcare team if these symptoms persist. Decreased interest in sex People may be less interested in sex because of hormonal therapy. This can be a permanent side effect when surgery is done to stop hormone production. Less interest or loss of interest in sex can also occur with hormonal drug therapy. It may continue as long as the hormonal drug therapy is taken, but sometimes it may be a long-term side effect. Discuss this with the doctor or healthcare team if it is a concern.
- Hot flashes
- Hot flashes and sweating can occur because of some hormonal therapies. This usually gets better as the body gets used to the treatment or when the drug is stopped. There are ways to manage menopausal symptoms such as hot flashes. Check with the doctor or healthcare team before taking herbal products to treat hot flashes because some may have hormonal properties that may affect a hormone-related cancer.
- Take hormonal therapy medications at night, but if hot flashes are worse at night, take them in the morning.
- Check with the doctor or healthcare team if these symptoms persist or become bothersome.
- Treatment-induced menopause can be permanent in women who have their ovaries surgically removed (oophorectomy) or have radiation therapy to the ovaries. It may be temporary when hormonal drug therapy is used, but for some women this can be a permanent problem, especially if they are near natural menopause when hormonal therapy is started.
- Symptoms of treatment-induced menopause are the same as natural menopause, but they may be more severe because treatment-induced menopause occurs quickly. Check with the doctor or healthcare team if menopausal symptoms become bothersome.
- There are ways to manage menopausal symptoms. For example, dietary supplements such as calcium and vitamin D may be used to help with loss of bone density (osteoporosis) associated with menopause.
- Breast swelling or tenderness
- Breast swelling or tenderness can occur in men and women because of some hormonal drug therapies. Check with the doctor or healthcare team if these symptoms become bothersome.
Erectile dysfunction Erectile dysfunction (ED) is also called impotence. ED is the consistent inability of men to keep an erection sufficient for sexual intercourse. This may be a long-term side effect. Some men may experience ED as a result of certain hormonal treatments for prostate cancer:
- Removal of both testicles – ED is usually permanent.
- Hormonal drug therapy – ED can be temporary.
- It can take 3–12 months after hormonal drug therapy is stopped to regain erectile function.
- If erectile function does not come back on its own, several treatments are available.
Check with the doctor or healthcare team about treatments for ED, such as prosthetic penile implants, vacuum devices and medications. Tumor flare reaction Symptoms of the cancer, such as bone pain, may worsen when a luteinizing hormone–releasing hormone (LHRH) agonist drug or tamoxifen (Nolvadex) is first used. This side effect is called a tumour flare reaction or a tumour flare response. Tumour flare reaction is a temporary side effect and usually goes away after a few weeks. Check with the doctor or healthcare team if the symptoms persist or become bothersome. Anti-androgens may be given before or along with LHRH agonists for 4–6 weeks to reduce tumour flare reaction in certain cases. Fertility problems can be temporary or permanent. A permanent loss of fertility (infertility) can be caused by surgical removal of the testicles or surgical removal of the ovaries. Hormonal drug therapy can also cause a temporary or permanent loss of fertility. Discuss options with the doctor or healthcare team if you are concerned about infertility. Diarrhea is an increase in the number and looseness of stools. It occurs because some hormonal therapy drugs affect the cells that line the gastrointestinal tract. Factors that increase the risk of diarrhea include the type and dose of hormonal drug used.
- Fatigue; Fatigue causes a person to feel more tired than usual and can interfere with daily activities and sleep. It occurs for a variety of reasons. Fatigue may be caused by anemia, specific drugs, poor appetite, depression, or it may be related to toxic substances that are produced when cancer cells break down and die. Fatigue may get better as time goes by. It can continue long after the person has finished their hormonal treatment.
- Muscle or joint pain; Muscle or joint pain may occur a few days after hormonal drug treatment begins. It is a little less common with anti-estrogens than with aromatase inhibitors. Taking medications such as acetaminophen (Tylenol) can help reduce this side effect. Check with the doctor or healthcare team if these symptoms persist or are bothersome.
- Blood clots; A blood clot may develop in the leg or lung during hormonal therapy. Symptoms include calf tenderness, a hardened vein, and pain or swelling in the legs, trouble breathing and chest pain. If you have any of these symptoms, see your doctor or go immediately to the nearest emergency department. A blood clot is treated with a blood-thinning medication called an anticoagulant (a substance that prevents coagulation (clotting) of blood).
- Bone density loss (osteoporosis); Osteoporosis is a long-term side effect that may occur with some hormonal drug therapies such as aromatase inhibitors and luteinizing hormone–releasing hormone (LHRH) agonists. The doctor may order a bone mineral density test before starting some hormonal treatments in order to provide a baseline for comparison with follow-up tests. Prevention and management of bone loss include calcium and vitamin D supplements, physical activity and drug therapy.
- Note: Other side effects may occur. For more detailed information on specific drugs, go to sources of drug information.
From Canadian Cancer Society http://www.cancer.ca
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