Treatment overview for cervical cancer

Transcription

1 Treatment overview for cervical cancer This information is an extract from the booklet Understanding cervical cancer. You may find the full booklet helpful. We can send you a copy free see page 6. Contents Early-stage cancer Locally-advanced cancer Advanced and recurrent cancer Treatment planning Treatment choices Talking about treatment Giving consent Benefits and disadvantages of treatment Treatment decisions Second opinion More information and support Cancer of the cervix can be treated with either surgery, radiotherapy, chemotherapy or a combination of these treatments. Your doctor will advise you on the best plan of treatment, taking into account a number of factors. These include your age and general health, and the type and stage of the cancer. Early-stage cancer Surgery is often the main treatment for cancer of the cervix in its early stages (where it is only in the cervix). Radiotherapy may be used as an alternative to surgery for early stage cancer. It is sometimes given after surgery if there is a risk that some cancer cells may be left behind. Macmillan and Cancerbackup have merged. Together we provide free, high quality information for all. Questions about cancer? Ask Macmillan of 6

2 This helps reduce the risk of the cancer coming back. Often radiotherapy is combined with chemotherapy for larger tumours in the cervix (over 4cm). This is known as chemoradiation. Chemotherapy is occasionally used before surgery, to shrink the cancer and make the operation easier, although this is rare. If it s given, it s usually combined with radiotherapy treatment. Locally-advanced cancer If the cancer has spread beyond the cervix, and can t be cured with surgery alone, radiotherapy is usually given in combination with chemotherapy rather than surgery. Advanced and recurrent cancer Chemotherapy may be given to women whose cancer has spread to other parts of the body or if the cancer comes back after radiotherapy. It is used in this situation to try to shrink and control the cancer and relieve symptoms, to prolong a good quality of life. This is known as palliative treatment. Occasionally an operation known as a pelvic exenteration may be carried out, although this is only suitable for a small number of women. Treatment planning In most hospitals a team of specialists will work together to decide which treatment is best for you. This multidisciplinary team (MDT) will include: a surgeon who specialises in gynaecological cancers (a gynaecological oncologist) a clinical oncologist (chemotherapy and radiotherapy specialist) a specialist nurse a consultant pathologist a radiologist. Page 2 of 6 Questions about cancer? Ask Macmillan

3 The team may include a number of other healthcare professionals such as: a dietitian a physiotherapist an occupational therapist a psychologist or counsellor a clinical trials nurse. Treatment choices Although it s usually clear that one treatment is better than another for your type and stage of cancer, if two are equally effective your doctors may offer you a choice of treatments. Sometimes people find it very hard to make a decision. If you re asked to make a choice, make sure that you have enough information about the different treatment options, what is involved and the side effects you might have, so that you can choose the right treatment for you. Talking about treatment Remember to ask questions about any aspects of your treatment that you don t understand or you feel worried about. You may find it helpful to discuss the benefits and disadvantages of each option with your cancer specialist or specialist gynaecological nurse. It often helps to make a list of questions and to take a close friend or relative with you. Giving consent Before you have any treatment your doctor will explain its aims and you will usually be asked to sign a form saying that you give your permission (consent) for the hospital staff to treat you. No medical treatment can be given without your consent, and before you are asked to sign the consent form you should have been given full information about: the type and extent of the treatment you are advised to have Questions about cancer? Ask Macmillan Page 3 of 6

4 the advantages and disadvantages of the treatment any other treatments that may be available any significant risks or side effects of the treatment. If you don t understand what you ve been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it s not unusual for people to need their treatment to be explained more than once. Patients often feel that the hospital staff are too busy to answer their questions, but it s important for you to be aware of how the treatment is likely to affect you and the staff should be willing to make time for you to ask questions. You can always ask for more time to decide about the treatment, if you feel that you can t make a decision when it is first explained to you. You re also free to choose not to have the treatment. The staff can explain what may happen if you don t have it. It s essential to tell a doctor or the nurse in charge, so that they can record your decision in your medical notes. You don t have to give a reason for not wanting to have treatment, but it can be helpful to let the staff know your concerns so that they can give you the best advice. Benefits and disadvantages of treatment Many people worry about having cancer treatments, because of the side effects that can occur. Although the treatments can cause side effects, it s usually possible to control these with medicines. Some people want to know what would happen if they do not have any treatment. Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation. In women with early-stage cervical cancer, surgery is often done with the aim of curing the cancer. Occasionally, additional treatments such as radiotherapy or a combination of radiotherapy and chemotherapy, are given after surgery to help reduce the risk of it coming back. With advanced cancer, surgery is not usually possible. However, treatment using a combination of chemotherapy and radiotherapy can still cure the cancer for some women. Page 4 of 6 Questions about cancer? Ask Macmillan

5 In other situations, treatment may be able to control the cancer, leading to an improvement in symptoms and a better quality of life. However, for some women the treatment will have little effect upon the cancer and they will have the side effects without a great deal of benefit. Treatment decisions If you have been offered treatment that is intended to cure your cancer, the decision whether to accept treatment may not be a difficult one. However, if a cure is not possible and the treatment is being given to control the cancer for a period of time, it may be more difficult to decide whether to go ahead. Making decisions about treatment in these circumstances is always difficult, and you may need to discuss in detail with your doctor whether you wish to have treatment. If you choose not to, you can still be given supportive (palliative) care, with medicines to control any symptoms. Complementary therapies may also be helpful and you can find out more about these from your nurses or the palliative care team. Second opinion Usually a number of cancer specialists work together as a team and they use national treatment guidelines to decide on the most suitable treatment for a person. Even so, you may want to have another medical opinion. Either your specialist, or your GP, should be willing to refer you to another specialist for a second opinion, if you feel it will be helpful. Having a second opinion may cause a delay in the start of your treatment, so you and your doctor need to be confident that it will give you useful information. If you do go for a second opinion, it may be a good idea to take a friend or relative with you, and have a list of questions ready; so that you can make sure your concerns are covered during the discussion. Questions about cancer? Ask Macmillan Page 5 of 6

6 More information and support If you have any questions about cancer, ask Macmillan. If you need support, ask Macmillan. Or if you just want someone to talk to, ask Macmillan. Our cancer support specialists are here for everyone living with cancer, whatever you need. Call free on , Monday Friday, 9am 8pm We make every effort to ensure that the information we provide is accurate but it should not be relied upon to reflect the current state of medical research, which is constantly changing. If you are concerned about your health, you should consult your doctor. Macmillan cannot accept liability for any loss or damage resulting from any inaccuracy in this information or third party information such as information on websites to which we link. Macmillan Cancer Support Registered charity in England and Wales (261017), Scotland (SC039907) and the Isle of Man (604). Registered office 89 Albert Embankment, London, SE1 7UQ Page 6 of 6 Questions about cancer? Ask Macmillan