CANCER TREATMENT OPTIONS: (With reference to Surgery and Radiotherapy)

Having hopefully picked up something of the ‘flavour’ of a typical oncology department’s essential make up and day-to-day functioning in my last blog, let us turn our attention now to what might be helpful and instructive, for both patient and carer, to know about anti-cancer treatments. Hopefully it will be readily appreciated that without such a basic understanding as I hope now to provide, we shall be ill-placed to review their psychosocial sequelae· in any meaningful or satisfactory way later on.

The aim of all cancer therapy is ultimately the complete eradication of cancer from the body, thus facilitating a return to normal pathways of healthy cell functioning. Present day approaches to anti-cancer treatment – boosted and bolstered as never before by “state-of-the-art” anaesthesia, antibiotic and analgesic control and management, ever-advancing imaging techniques and the assurance of an adequately controlled protective environment – are a ‘far cry’ from earlier times. The comparatively recent emergence of combination cancer therapy, in which surgery, radiotherapy and chemotherapy work ‘hand-in-glove’ in their fight against cancer has vastly improved the chances not only of effective and readily managed control but also of outright cure.

Radiotherapy may also be used to control the growth of localised and sometimes inoperable tumours, as well as to treat what are referred to as “metastatic lesions” or secondary growths in other parts of the body. Radiotherapy may well be employed with curative intent and in such cases, is referred to as “radical radiotherapy”. On other occasions it may be used to palliate or control symptoms.  Its invariable aim is to reduce and, where possible and feasible, eliminate cancer cells altogether whilst sparing as much normal tissue as possible.

Treatment is given in “fractions” or regular amounts and of an order that the body can tolerate over, typically, a four to six week period. Radiotherapy does not, of course, discriminate between cancerous and healthy cells; and for this reason throughout the entire period of treatment, regular monitoring of white blood cells will occur. Should such cells become suppressed beyond tolerable limits, susceptibility to infection will ensue. Let me again commend for your further reading any one of the very many expertly written descriptive accounts·· of surgery, radiotherapy and other anti-cancer therapies, (which these prescriptions in letter form are most certainly not intended to be).

The most common side-effect of radiotherapy affecting mood and behaviour (and, depending on the nature and extent of the operation performed, to a lesser extent surgery also) is likely to be tiredness and feelings of malaise and fatigue. However, this by no means will be experienced by every patient and where, as a side-effect of radiotherapy, such chronic tiredness does occur, it is more likely to come about in a cumulative fashion – building up progressively over the days and weeks of treatment.  Notwithstanding this fairly common delayed response, it is a good idea right from the very outset of a course of radiotherapy to plan each daily schedule accordingly. This should allow for a full quota of night sleep/rest, which over time, it may well be necessary and desirable to increase. This can be done by retiring a little earlier in the evening or by taking a ‘longer lie’, as the case may be or even by taking a nap during the course of the day.

Remember too that fatigue and weariness are likely to be at their worst when we are bored and lacking incentive or direction.  It is no bad plan therefore to counter this possibility by having to hand a supply of easy listening (audio tapes/CDs) or videotapes of favourite programmes or films or whatever.  Crosswords, jigsaws, modelling kits and the like also provide excellent time fillers, with no small measure of occupational therapy thrown in. Planning of this kind is, of course, very much up to the individual concerned but is well worth a little time spent in preparation.

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