After receiving your prognosis, your doctor will discuss treatment options with you.
A broad team of healthcare professionals are involved in discussing potential treatments and what is best for you as the patient. This is known as a Multi-Disciplinary Team and may involve the following:
You may also be seen by other health or social care professionals such as physiotherapists, dietitians, occupational therapists, radiographers, doctors/nurses specialising in symptom control, counsellors or psychologists.
Your doctor will present you with options for treatment. This may include a plan that involves one or more treatments. They will tell you the pros and cons of the suggested plans and will be able to give you a professional opinion on what treatments will give you the best chance of beating cancer or delaying its progression. You should also be told any significant risks or side effects from treatment and should be given alternatives.
Once you have agreed on a treatment plan with your doctor, you will need to give your consent to the treatment. This usually involves you signing a form. In some cases, patients may decide to decline treatment. This is your right. Your doctor will explain the risks of refusing treatment and what may happen. You do not have to give your reasons for declining treatment but sometimes explaining your concerns may allow doctors to come up with a solution or alternative that you are happy with.
Although national treatment guidelines will be used to give you the most suitable treatment, you may decide you are unhappy with it. In this case, you can ask for a second opinion. This is not a legal right, but many doctors will be happy to refer you. Sometimes your consultant may not be able to refer you to some specialists for a second opinion due to funding reasons. They may advise you to talk to your GP about getting a second opinion from another specialist. If you would like a second opinion from your GP, you can ask to see another GP at your surgery.
Questions to ask about your treatment.
After treatment ends, in some cases, this may be the end of a patient’s cancer journey. They may be unlikely to need any more treatment and can be considered cancer-free – or in remission. For other cases, a doctor will discuss with you if your cancer requires a more long-term treatment plan, managing your cancer over some time. You will discuss this with someone from your cancer team. They will tell you what to expect after treatment finishes and will tell you about your follow-up care.
Late effects or long-term side effects are side effects that do not go away after treatment. They may also not appear until a few months or years after your treatment. Your cancer care team will inform you of any risks of late effects of the treatments that you have. They can inform you of what to look out for. They may also tell you if there are any regular tests you can have done to ensure any problems are found quickly. Ask your cancer care team if there is anything you can do to reduce the risk of developing these late effects. The team will also be able to tell you how to manage these.
Below are some examples of the late effects that can occur because of cancer treatment. These effects are dependent on the type of cancer treatment you have had.
Sex and fertility – Cancer treatment can impact your sex life and fertility. In some cases, patients experience a temporary or permanent loss of fertility (both males and females).
Lymphoedema – Radiotherapy or surgery to lymph nodes can cause lymphoedema or swelling. This usually affects your arms or legs but can affect other body parts as well, depending on the area that was treated. Follow the advice from your cancer care team to reduce the risk of this developing. Make sure you look after and protect the skin around the treated area. Make sure you tell a doctor or nurse as quickly as possible if you notice any swelling. Prompt treatment will mean the condition is managed more easily.
Effect on bones –
Effect on the head and neck – Radiotherapy to the head can cause:
Effects on the bowel and bladder – Radiotherapy to the lower tummy area can cause issues with the bowel and bladder. These can often be managed quite easily.
Effects on heart and lungs – Some drugs used in cancer treatment may cause heart problems, for example, high blood pressure or abnormal heart rhythms. If you are at risk, you will have regular check-ups before, during and after your treatment. Radiotherapy of the chest or the left breast can sometimes increase the risk of heart problems. Radiotherapy of the lungs can cause scarring.
Second cancer – Certain cancer treatments may increase your overall risk of developing second cancer in the future. Your cancer care team will explain all the risks to you but often the benefits of treatment will be greater than the risk.
It is important to talk to your doctor about any late side effects that do not go away or any new ones that appear.