Certainly, getting a cancer diagnosis is one of the scariest moments of life. You worry about your chance of survival and the impact cancer will have on you and your family. Additionally, it’s natural to worry about how you will manage possible treatment side effects. Before treatment can begin, you and your doctor will discuss available options. Importantly, your treatment options will depend on your type of cancer, if it has spread and where, and your overall health. While considering which treatment(s) to choose, it’s important for you to understand cancer treatment options.

The cancer treatment options available for you will depend on a variety of factors, including the following: your type and stage of cancer, if it’s spread to other body parts, and your overall health.

Surely, when facing cancer treatment, the thought of coping with side effects can be overwhelming. However, keep in mind that the side effects you experience will depend on the treatment you receive and how your body responds to it. Everyone has their own unique experience. Talk to your doctor about what you should expect and how you can reduce your discomfort.

This post covers the following cancer treatment options:

Precision medicine, including targeted therapy and immunotherapy.
Biomarker testing.
Chemotherapy.
Radiation.
Surgery.

Additionally, an upcoming post will cover the following cancer treatment options:

Hyperthermia.
Photodynamic therapy.
Hormone therapy.
Stem cell transplants.

Importantly, the information provided in this post is only a summary. I urge you to ask your doctor for more information. And if you have time, conduct further research on your possible treatment options on reputable websites. You can find a list to get your started in our resource center.

Cancer Treatment Options: Precision medicine.

Precision medicine, also called personalized medicine, is an approach to medical care in which disease prevention, diagnosis, and treatment are tailored to your genes, proteins, and other substances.

For cancer treatment, precision medicine means using biomarker and other tests to choose treatments most likely to help you, while at the same time sparing you from getting treatments that are not likely to help.

Although the concept of personalized medicine is not new, recent advances in science and technology have helped accelerate research.

For instance, scientists now know that cancer cells can have many different changes in genes, proteins, and other substances that make the cells grow and spread. Additionally, they learned that even two people with the same type of cancer may have different changes in their cancer. Importantly, some of these changes impact how certain cancer treatments work.

Your doctor might use precision medicine to:

Correctly diagnose your specific type of cancer.
To select treatments that are most likely to help you, while at the same time sparing you from getting treatments that are not likely to help.
To evaluate how well your treatment is working.

Unfortunately, precision medicine is not a part of routine care for most cancer patients. Rest assured that the “standard” approach to cancer treatment (choosing treatments based on the type of cancer you have, its size, and whether it has spread) is effective and personalized to each patient.

Two types of precision medicine that could be available to you are targeted therapy and immunotherapy.

Cancer treatment options: Targeted therapies.

A type of precision medicine, targeted therapy stops or slows the growth or spread of cancer at the cellular level. Targeted therapies are designed to target the molecules that cancer cells need to survive, thereby slowing or stopping cancer’s growth.

This type of treatment can be given in a pill or through an infusion. Additionally, your doctor may recommend that you simultaneously receive chemotherapy or immunotherapy treatments.

Targeted therapy uses two types of drugs:

Small molecule drugs that can easily enter the cancer cells and interfere with the molecules inside. Also, they can interfere with molecules on the surface of the cell.

Larger monoclonal antibodies are proteins made in a lab to target molecules on the surface of the cancer cells. Some of these antibodies mark cancer cells so the immune system can better detect and destroy the cancer. Other monoclonal antibodies stop cancer cells from growing or cause them to self-destruct. Lastly, they can deliver toxins directly into a cancer cell.

Side effects of targeted therapies.

Although side effects can vary depending on the treatment and the patient, common side effects include:

Skin problems, such as rash.
Elevated liver enzymes, which may lead to a change in the drug dosage.
Diarrhea or constipation.
Nausea and vomiting.
Fatigue.
Low red blood cell count, leading to fatigue.
Low white blood cell count, which may increase risk of infection.
Poor blood clotting and wound healing.
High blood pressure.

Cancer treatment options: Immunotherapy.

The immune system, made up of a complex network of organs, cells, and proteins, helps your body fight infections and other diseases. The good news is that the immune system can prevent or slow the growth of cancer. However, the bad news is that cancer cells can avoid the immune system’s destruction in a variety of ways.

Immunotherapy helps your immune system fight cancer.

What are the different types of immunotherapy?

Importantly, doctors use several types of immunotherapy to treat cancer, including:

Immune checkpoint inhibitors drugs block immune checkpoints, allowing your immune cells to respond more strongly to cancer cells.
T-cell transfer therapy boosts the natural ability of your T cells to fight cancer.
Monoclonal antibodies are immune system proteins created in a lab to mark cancer cells so your immune system can more easily identify and destroy cancer cells. This type of monoclonal antibodies are considered a type of immunotherapy.
Treatment vaccines boost your immune system’s response to cancer cells.
Immune system modulators enhance your body’s immune response against cancer.

What types of cancers are treated with immunotherapy?

Currently, immunotherapy drugs successfully treat 15 types of cancer, including cancer of the skin, lung, kidney, and bladder. Fortunately, researchers are studying immunotherapy in just about every type of cancer.

How is immunotherapy administered?

There are many methods used to deliver immunotherapy, including:

Intravenously (IV).
A pill or capsule you swallow.
A cream you rub into your skin.
Directly into the bladder.

Where can you receive immunotherapy?

You may receive this type of treatment at your doctor’s office or in a clinic. Or you may receive treatment at a hospital, but you won’t have to stay overnight.

How often will you need immunotherapy?

The frequency and duration of your treatments will depend on many factors, including the type and stage of your cancer, the type of immunotherapy, and how your body reacts.

Interestingly, you may receive treatments every day, week, or month.

What are the side effects of immunotherapy?

Immunotherapy treatment can last for months, and in some cases 2 years or more. Importantly, you can develop side effects at any point during or after the treatments.

The following side effects can occur with all types of immunotherapy:

Skin reactions at the needles site, such as pain and redness.
Flu-like symptoms.
Swelling and weight gain from retained fluid.
Heart palpitations.
Sinus congestion.
Diarrhea.
Infection.
Organ inflammation.

In rare cases, patients develop severe or fatal allergic and inflammation-related reactions.

Also, the different types of immunotherapy have their own set of additional potential side effects.

How often does immunotherapy work?

Unfortunately, only a small portion of people who receive immunotherapy will respond to the treatment. In fact, experts state that only 15-20% of patients achieve durable results with immunotherapy.

Precision medicine isn’t available for all cancers.

Importantly, precision medicine is not currently an option for every type of cancer. However, If you have a cancer for which treatment options could depend on changes in the genes or proteins of the cells, your doctor will likely conduct tests on your cancer cells.

Fortunately, there are many common cancers for which doctors use precision medicine to help make treatment decisions, including:

Colorectal cancer
Breast cancer
Lung cancer
Certain types of leukemia
Certain types of lymphoma
Melanoma
Esophageal cancer
Stomach cancer
Ovarian cancer
Thyroid cancer

Cancer treatment options: Biomarker testing.

Biomarker testing looks for genes, proteins, and other substances (called biomarkers or tumor markers) in both solid tumors and blood cancers. Since every cancer has a unique pattern of biomarkers, this testing can provide information that can impact how your cancer responds to treatments.

Because some treatments may only work for cancers with certain biomarkers, biomarker testing could help you and your doctor choose a cancer treatment that is most likely to help. Conversely, this testing can spare you from receiving treatments that are unlikely to help.

Interestingly, biomarker testing for cancer treatment may also be called:

Tumor testing.
Tumor genetic testing.
Genomic testing or genomic profiling.
Molecular testing or molecular profiling.
Somatic testing.
Tumor subtyping.

How do biomarker tests work?

Importantly, biomarker testing requires a sample of your cancer cells. If you have a solid tumor, your doctor may get a sample during surgery or a biopsy. If doctors cannot safely access your tumor for a biopsy, or if you have a blood cancer, your biomarker test will use a blood sample (a type of “liquid biopsy”).

Note that in some cases, you will also need to give a sample of your healthy cells via your blood, saliva, or a small piece of your skin.

A lab will then test your sample for certain biomarkers and create a list of treatments that might work for you based on your results, referred to as “matching therapies”.

What to expect from your biomarker test.

Your results could show that your cancer has a certain biomarker that is targeted by a known therapy, which means that therapy may help you. Importantly, the matching therapy may be:

An FDA-approved treatment.
An off-label treatment (approved for a different ailment than the one you have).
Only available in a clinical trial.

Additionally, biomarker testing may find changes in your cancer that don’t provide information helpful in determining possible treatment options.

Is biomarker testing available to all cancer patients?

Unfortunately, biomarker testing is not available to all patients. In fact, not all hospitals offer this kind of testing. When available, doctors usually suggest biomarker testing for people with cancer that has spread or come back after treatment. Additionally, doctors routinely use biomarker testing for certain types of cancer, including non-small cell lung cancer, breast cancer, and colorectal cancer.

Ask your doctor if biomarker testing should be part of your care. And to avoid surprise bills, ask your health insurance provider if they cover biomarker testing for your cancer.

Will biomarker testing help you?

Unfortunately, biomarker tests don’t help everyone. For instance, these tests may not help you if:

Doctors cannot safely get a biopsy for testing.
There is not enough tumor tissue in your biopsy sample.
The test doesn’t find biomarkers that match any available treatments.
The test identifies a matching therapy that would be used off-label, but your insurance won’t cover the treatment.
Your test identifies a matching therapy that is being tested in a clinical trial, but you cannot participate in the trial.
The test identifies a matching treatment, but the treatment does not work for you.
Not all your cancer cells have the same biomarkers.
The biomarkers in your cancer change over time, making the initial test irrelevant.

Another type of biomarker.

Importantly, circulating tumor biomarkers – found in the blood, urine, stool, or other bodily fluids of some cancer patients – can help doctors diagnose and monitor cancer during and after treatment. Your doctor may use circulating tumor markers to:

Estimate your prognosis.
Determine your stage of cancer.
Find cancer that remains after treatment or has returned after treatment.
Assess how well a treatment is working.
Monitor whether a treatment is no longer working.

To learn more, visit the National Cancer Institute’s Tumor Markers fact sheet.

Cancer treatment options: Chemotherapy.

Chemotherapy, which slows or stops cancer cells, is widely used to treat many types of cancer and to ease symptoms.

Depending on your situation, you may receive chemotherapy on its own, or chemotherapy combined with other cancer treatments. For detailed information on chemotherapy, read my post 7 Important Things to Know About Chemotherapy.

Cancer treatment options: Radiation.

Radiation therapy, also called radiotherapy, uses radiation to kill cancer cells, which causes tumors to shrink and eases cancer symptoms.

For detailed information on radiation therapy, read my post Important Things to Know About Radiation Treatment.

Cancer treatment options: Surgery.

In some cases, tumors and precancerous tissues can be surgically removed with:

Scalpels or other sharp tools.
Cryosurgery which exposes tissue to extreme cold using either liquid nitrogen or argon gas.
Lasers which destroy cells with wavelengths of light.

Although it’s possible you may only need surgical treatment, you will likely need another type of treatment as well.

The goals of cancer surgery.

Importantly, depending on your type of cancer and how advanced it is, the goal of your surgery may be to:

Remove your entire tumor.
Remove some, but not all, of a tumor (called debulking). This procedure can improve the effectiveness of other treatments.
Reduce your cancer symptoms by removing tumors that cause pain or pressure.

During your procedure, the surgeon will remove the cancerous tissue. Additionally, he/she will likely remove some healthy tissue around it to improve the chances that all the cancer cells have been removed. Furthermore, in some cases surgeons remove lymph nodes or other tissues which are sent to a lab for inspection to determine if the cancer has spread.

Minimally invasive vs open surgery.

In open surgery, the surgeon makes one large cut to remove the tumor and other tissue. The size of the cut can slow recovery.

During minimally invasive surgery the doctor makes only a few small cuts. Then the surgeon uses a laparoscope (a long, thin tube with a camera) to view the surgical area, while using special surgical tools inserted through other small cuts to remove the tumor and other tissues. Unsurprisingly, the smaller cuts make recovering easier.

What types of cancer are treated with surgery?

Surgery works best for solid tumors contained in one area. Importantly, surgery is not an option for blood cancers or for cancers that have spread to other body parts.

What are the risks?

Although surgeons are highly trained professionals who try their hardest to ensure good outcomes, problems can arise. For instance, you may develop pain or an infection in your surgical site.

Where will your surgery take place?

If your procedure requires an overnight stay, you will have your surgery in a hospital. If your doctor expects you to go home a few hours after your procedure, you may have your surgery in the doctor’s office, a surgery center, or a hospital.

Additionally, the location for your surgery will also depend on other factors, including:

The type of surgery.
How extensive the surgery will be.
Where the surgeon practices.
Your insurance coverage.

Before agreeing to surgery in a freestanding surgery center, I suggest you read How Safe are Surgery Centers?

Preparing for surgery.

Prepare yourself by asking the right questions and following your doctor’s guidance for the period before and after your surgery. Read these posts for more information and tips:

Choosing a treatment.

Choosing a treatment for cancer can be a complicated, scary process. You may have several options to consider, or there may be only one viable option. And sometimes, your only choice may be a clinical trial.

Importantly, you must actively participate in the decision-making process. This is your body – you get to decide how you want to proceed. Discuss your options with your doctor. And whenever possible, get a second opinion. For more information on this important topic, read Why are Second Opinions Important? and The Importance of Shared Decision-Making in Healthcare.

Before deciding, you may find it helpful to review the PDQ® cancer treatment summaries for adult and childhood cancers.

Lastly, to find out if there are open trials for which you may be eligible, use the search tool at Find NCI-Supported Clinical Trials or contact the NCI’s Cancer Information Service for help.

Paying for treatment.

Certainly, cancer treatment can be expensive, even with health insurance. But there are organizations that offer financial support. Visit the NCI database, Organizations that Offer Support Services and search for “financial assistance.” Or call toll-free 1-800-4-CANCER (1-800-422-6237) for information.

Additionally, visit Zaggo’s resource center for a list of organizations.

Can you work during cancer treatment?

Certainly, you may be able to work while receiving cancer treatment, but you may have to adjust your work schedule to accommodate your stamina. Unsurprisingly, your ability to work will depend on many factors, including the type of treatment you undergo, and the type of work you perform. You should talk with your employer about ways you can adjust your work during your cancer treatments.

Interestingly, your employer must provide reasonable accommodations if you are eligible under the ADA or your state’s fair employment law. However, your employer does not have to accommodate you if they can show the accommodation you want would create an undue hardship or pose a direct threat.

Learn more…

Understanding your cancer treatment options is just one important part of dealing with a cancer diagnosis. Therefore, I suggest you read these posts:

Understanding Cancer Treatment Options

Cancer Treatment Options: Precision medicine.