Getting a cancer diagnosis is probably one of the scariest things that can happen to a person. Certainly, you worry if cancer will take your life. And you worry if you will be able to tolerate the treatments, including the potential impact on the quality of your life. Fortunately, advances in research have improved cancer treatments, providing patients with treatments unavailable years ago. However, all the options can make it overwhelming to choose a cancer treatment.

Whether you are newly diagnosed, or learning your current treatment is no longer working, you will likely have to choose a cancer treatment. Learning the pros and cons of each treatment option can help you choose which cancer treatment works best for you.

This post covers the following cancer treatment options:

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

Read my companion post for information following cancer treatment options:

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

Cancer treatment option: Hyperthermia.

In hyperthermia treatment – also called thermal therapy, thermal ablation, or thermotherapy – small areas of tissue are exposed to high temperatures. Interestingly, the high heat can damage and kill cancer cells, with little or no harm to normal tissues. Additionally, hyperthermia treatment can make other cancer treatments (such as radiation and chemotherapy) work better.

Importantly, hyperthermia can treat either small or large areas of your body, or even your entire body.

How is the heat created?

There are many techniques used to create heat for these treatments, including:

Probes that make energy from microwaves.
Radio waves (also called radiofrequency).
Lasers.
Ultrasound.
Heating fluids (such as blood or chemotherapy drugs) and then putting the warm fluids into the body (called perfusion).
Placing the entire body in a heated chamber or hot water bath or wrapping the patient with heated blankets.

The drawbacks of hyperthermia treatments.

Firstly, this kind of treatment requires special equipment and expertise that is not widely available. And, most importantly, it is not clear if it helps cancer patients live longer.

Side effects.

Although most healthy tissue is not harmed during treatment, in some cases the higher temperatures can cause burns, blisters, and pain. Additionally, the “perfusion” treatments (putting warm fluids in the body) can cause damage to the normal tissues in the treatment area, including swelling, blood clots, and bleeding. Lastly, whole-body hyperthermia can cause diarrhea, nausea, and vomiting. In rare cases, it can cause heart and blood vessel issues.

How can you get hyperthermia treatment?

Importantly, hyperthermia treatment is currently not widely available, but some hospitals and cancer centers offer it. However, doctors are studying hyperthermia in clinical trials. If you are interested in participating in a trial, search for a options using the National Cancer Institute’s advanced clinical trials search form or contact NCI’s Cancer Information Service.

Cancer treatment option: Photodynamic therapy.

Photodynamic therapy (also called PDT) uses drugs that are activated by light to kill cancer cells. The light, which can come from a laser, LEDs, or other source, destroys the blood vessels in the tumor which prevents it from growing. Additionally, it can also cause the immune system to attack cancer cells, even in other parts of your body.

When is photodynamic therapy used?

This treatment is most often used to treat a specific part of the body.

The FDA has approved photodynamic therapy to treat some cancers and precancerous conditions, including:

Actinic keratosis.
Advanced cutaneous T-cell lymphoma.
Barrett esophagus.
Basal cell skin cancer.
Esophageal (throat) cancer.
Non-small cell lung cancer.
Squamous cell skin cancer (at stage 0).

Additionally, doctors also use photodynamic therapy to relieve symptoms of some cancers, including:

Esophageal cancer when it blocks the throat.
Non-small cell lung cancer when it blocks the airways.

How is photodynamic therapy administered?

Firstly, you get a photosensitizing medication – either orally, spread on your skin, or through an IV. After 24-72 hours, most of the medication will have left normal cells, but will remain in cancer or precancer cells. Next, your tumor will be exposed to the light source, which creates a form of oxygen that kills cancer cells.

The method of applying the light is based on the location of the tumor. For instance, for skin cancer, the light is aimed right at the tumor. And for throat or lung tumors, the light passes through a fiber optic cable placed down your throat.

Patients with cutaneous T-cell lymphoma receive extracorporeal photopheresis (ECP) therapy. For this treatment, a machine collects your blood cells, treats them with a photosensitizer, exposes them to light, and returns them to your body through a needle in a vein.

Benefits of photodynamic therapy.

Generally, there is little damage to healthy cells. Additionally, the therapy doesn’t cause scarring, which can be a concern for those with cancer or precancer of the skin.

The negatives of photodynamic therapy.

Unfortunately, the inability for light to pass through more than 1 centimeter of tissue means some body parts cannot be reached with this treatment. And it can’t reach very far into large tumors.

Furthermore, the therapy can sometimes harm normal cells. And you may experience the following side effects, which can vary depending on the type and area of treatment.

Common side effects include:

Burns, redness, swelling, pain, itching, and scarring in the treatment area.
Coughing.
Trouble swallowing.
Stomach pain.
Painful breathing.
Shortness of breath.

Additionally, the photosensitizer “porfimer sodium” makes eyes and skin sensitive to light for about 6 weeks. If you have treatment with this type of drug, you should avoid direct sunlight and bright indoor lights.

Finally, those who receive ECP may experience these side effects:

Brief periods of low blood pressure.
Faster than normal heart rate.
Anemia.
Low blood platelet count.

Fortunately, side effects improve once your treatment has ended.

How can you get photodynamic therapy?

Importantly, only a small number of hospitals and cancer centers provide this type of therapy. However, clinical trials are underway. If you want to participate in a trial, search for a options using the National Cancer Institute’s advanced clinical trials search form or contact NCI’s Cancer Information Service.

Cancer treatment option: Hormone Therapy.

Hormone therapy slows or stops the growth of prostate and breast cancers that use hormones to grow. This treatment can:

Treat cancer by stopping or slowing cancer’s growth. It can also reduce the chance it will return.
Ease cancer symptoms in men with prostate cancer who cannot have surgery or radiation therapy.

Generally speaking, there are two types of hormone therapy: those that block the body’s ability to produce hormones and those that interfere with how hormones behave in the body.

How is hormone therapy administered?

You could receive hormone therapy through:

Pills that you swallow.
Injections into a muscle or right under the skin.
Surgery to remove hormone producing organs: ovaries for women or testicles for men.

Hormone therapy can help other cancer treatments.

Hormone therapy, when used alongside other cancer treatments, can:

Make a tumor smaller before surgery or radiation therapy.
Decrease the risk that cancer will come back after the primary treatment.
Destroy cancer cells that have returned or spread to other parts of your body.

The side effects of hormone therapy.

Side effects experienced by men who receive hormone therapy for prostate cancer include:

Hot flashes.
Loss of interest in or ability to have sex.
Weakened bones.
Diarrhea and/or nausea.
Enlarged and tender breasts.
Fatigue.
Weight gain.

photo of a sweaty middle-aged woman having a hot flash, holding a portable fan And side effects for women who receive hormone therapy for breast cancer can include:

Hot flashes.
Vaginal dryness.
Changes in your periods if you have not yet reached menopause.
Loss of interest in sex.
Nausea.
Mood changes.
Fatigue.

Cancer treatment option: Stem cell transplant.

Stem cell transplants restore blood-forming stem cells for people whose blood-forming cells were destroyed by high doses of chemotherapy or radiation therapy used to treat certain cancers.

Our blood-forming stem cells are vital because they grow into different types of blood cells:

White blood cells which help your body fight infection.
Red blood cells which carry oxygen throughout your body.
Platelets which help the blood clot and prevent bleeding.

How do stem cell transplants work against cancer?

Importantly, stem cell transplants do not usually work directly against cancer. Instead, these transplants restore your body’s ability to produce new blood cells after chemotherapy or radiation.

However, in leukemia, may work against your cancer directly since a stem cell transplant with stem cells from a donor can attack any remaining cancer cells.

What types of patients receive stem cell transplants?

Generally, stem cell transplants are used for the following cancers:

Blood cell cancers, such as leukemia, lymphoma, multiple myeloma, and myelodysplastic syndromes.
Neuroblastoma.
Ewing sarcoma.
Germ cell tumors.
Testicular cancer.
Pediatric brain tumors that have come back after initial treatment.

Research is underway to determine if stem cell transplants would benefit people with other types of cancer.

Types of stem cell transplants.

When you receive a stem cell transplant, you get healthy stem cells through a needle in your vein. Most of these cells come from the bloodstream, but you may also get cells from bone marrow or a baby’s umbilical cord.

Once the healthy stem cells enter your blood, they travel to your bone marrow where they replace the cells destroyed by chemotherapy or radiation.

The type of transplant you receive is determined by the source of stem cells transplanted:

Autologous – when you use your own stem cells.
Allogeneic – when you use someone else’s stem cells. The cells may come from a blood relative or an unrelated person whose cells are a good match.
Syngeneic – when you use stem cells from your identical twin.

Since you likely don’t have an identical twin, you will probably have either an autologous or allogeneic transplant.

Importantly, there are benefits and risks to each type:

With autologous transplants, the transplanted cells will match because they come from your body. However, there is a small risk that some cancer cells may get transplanted along with healthy stem cells.

On the other hand, if you have an allogeneic transplant, there is a chance your body will identify the transplanted cells as foreign and will therefore destroy the new cells.

Mini and tandem transplants.

Mini-transplants, a type of allogeneic transplant, uses lower doses of cancer treatment than you would receive for a regular transplant. Therefore, it kills some, but not all, of your stem cells. Mini-transplants can prevent rejection of the donor’s cells by suppressing your immune system.

For tandem transplants, a type of autologous transplant, you would get a round of high-dose chemotherapy before your stem cell transplant. Then, after many weeks or even months, you get another chemotherapy round followed by another stem cell transplant.

Which type of transplant could you get?

If your doctor determines you could be a good candidate for a stem cell transplant, he/she will consider many factors to determine which type of transplant is best for you, including:

The type and stage of your cancer.
If you can use your own stem cells.
The availability of matching donor stem cells.
Other treatment options.
Your ability to tolerate high doses of chemotherapy.
Your overall health condition.
Treatment history.

Side effects of stem cell transplants.

In addition to the side effects you could experience from high doses of chemotherapy needed before a stem cell transplant, you could also experience side effects from the transplant.

Importantly, short-term side effects include:

Nausea and vomiting.
Fatigue.
Appetite loss.
Mouth sores.
Hair loss.
Skin reactions.

Additionally, you may experience longer-term side effects, including:

Infertility.
Cataracts.
New secondary cancers.
Damage to your liver, kidney, lung, and/or heart.
Bone and muscle weakness.

Graft-versus-host disease (GVHD).

If you receive a transplant with donor cells, you could develop GVHC – a serious problem which can occur when the donated white blood cells (the graft) think the cells in your body (the host) are foreign and therefore attacks them. Unfortunately, GVHD can damage your skin, intestines, liver and other organs.

Ask your doctor how to reduce your risk of GVHD.

Where can you get a stem transplant?

For an allogeneic transplant, you will need to go to a hospital with a specialized transplant center. You can search on The National Marrow Donor Program’s website for a list of transplant centers in the US.

How to choose a cancer treatment.

Certainly, it can feel overwhelming to choose a cancer treatment. You may have multiple options to consider, or there might only be one available treatment. Or your only choice may be a clinical trial.

Importantly, you must actively participate in the decision-making process. This is your life – you must choose a cancer treatment that makes sense for you. Of course, you should discuss your options with your doctor. And whenever possible, you should get a second, or even third, 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, no matter which cancer treatment you choose, your expenses related to your treatment can add up, even with health insurance. Fortunately, many organizations offer financial support. To find help, 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 that may be able to help you.

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. 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…

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

How to Choose a Cancer Treatment