We are made up of trillions of cells that over our lifetime normally grow and divide as needed. When cells are abnormal or get old, they usually die. Cancer starts when something goes wrong in this process and your cells keep making new cells and the old or abnormal ones don’t die when they should. As the cancer cells grow out of control, they can crowd out normal cells making it hard for your body to work the way it should.
Cancer is more than one disease, in fact there are more than 200 different kinds of cancer that can develop anywhere in the body and is named for the part of the body where it started. Different types of cancer can behave very differently. For example, lung cancer and breast cancer are very different diseases. They tend to grow at different rates and respond to the various forms of treatment differently. It is for this reason that people with cancer need treatment tailored to their particular type of cancer.
Although a number of cancers share risk factors, most cancers have a unique set of risk factors that are responsible for their onset. Some cancers occur as a direct result of smoking, dietary influences, infectious agents or exposure to radiation, while others may be a result of inherited genetic faults. For many cancers, the causes are unknown. While some of the causes are modifiable through lifestyle changes, some others are inherited and cannot be avoided.
The sooner a cancer is found, and treatment begins, the better the chances are for living years.
We would like to thank Cancer Council NSW for allowing us to use information from its website in various parts of this section.
Sarcomas are a group of cancers that start in the bones or the soft tissues (muscle, fat, and fibrous tissues). They are rare tumours, and make up only 1% of cancers in adults.
These cancers often cause a lump or swelling in the affected body party which results in people seeking medical advice. The other common problem especially if the sarcoma has started in a bone is pain or a dull ache, which is often worse at night.
When a sarcoma is suspected, a series of tests are performed to identify the stage of the tumour. This involves MRI and CT scans and X-rays to identify the extent of the cancer in the area where it has started, and whether or not there has been spread to other parts of the body. To work out the exact type of cancer that is present, a sample (known as a biopsy) needs to be removed. Sometimes this is performed with a small operation, while other times a needle can be inserted into the cancer and a sample removed.
Treatment of sarcomas requires the involvement of a team including surgeons, medical and radiation oncologists, nurses, physiotherapists along with many others. This is known as a multidisciplinary team (MDT), and members of this team will often work together alongside each other in a specialised clinic. In the background, other specialists, such as pathologists and radiologists help with the interpretation of tests such as biopsies and scans.
Treatment for people with sarcoma is individualised. This means that they type of treatment that someone receives may be different to another person with the same disease because of differences in age, other illnesses, preferences, and the precise extent and nature of their cancer. In general, however, sarcomas are treated with surgical removal. Often, chemotherapy is given before and/or after an operation to remove a sarcoma, and radiation therapy is also used on occasions. If you are a patient, it is important to discuss the treatment options that may be available to you with your treating team.
A brain tumour forms when cells grow and divide in an uncontrollable way. When this occurs, the tumour takes up space within the skull and can interfere with the brain’s normal activity.
A tumour may cause damage by increasing pressure in the brain, by shifting the brain and causing it to push against the skull, and/or by invading and damaging nerve and healthy brain tissue.
Brain tumours can be benign or malignant (brain cancer).
The symptoms of a brain or spinal cord tumour depend on where it is located and if it is causing pressure in the skull or spinal column. Sometimes, when a tumour grows slowly, symptoms develop gradually or you may not take much notice of them. They may be similar to other illnesses, such as a migraine or a stomach bug (e.g. headaches or nausea).
Brain and spinal cord tumours may cause weakness or paralysis in parts of the body. Some people also have trouble balancing or have seizures.
Other symptoms of brain tumours include:
Symptoms of spinal cord tumours include:
Most people who have common symptoms, such as a headache, do not have a tumour. However, new or worsening symptoms should be reported to your doctor.
Your GP will probably arrange the first tests to assess your symptoms. You will usually be referred to a neurologist, who will arrange further tests and advise you about treatment options.
Tests to diagnose brain cancer:
Other tests that are sometimes used are:
Surgery
Surgery in the central and peripheral nervous system is called neurosurgery. In many cases, removing all or part of the tumour may allow you to lead an active life for some time. However, you may also have other treatments.
Some tumours can be removed by neurosurgery. This type of operation is called a gross total resection. In other cases, the surgeon may only be able to remove part of the tumour. This is called a partial resection or debulking. Partial removal may be because the tumour is widespread, near major blood vessels, or cannot be removed without damaging other important parts of the brain or spinal cord. A partial resection may improve your symptoms by reducing the pressure on your brain.
Sometimes a tumour cannot be removed because it is too close to certain parts of the brain and would cause serious problems. This is called an inoperable or unresectable tumour. Your doctor will talk to you about other ways to try to ease the symptoms.
Radiotherapy for brain and spinal cord tumours
Radiotherapy (also called radiation therapy) is a type of treatment that uses high-energy x-ray beams to kill or damage cancer cells.The radiation is specifically targeted at the treatment site to reduce the risk of damage to healthy cells. The treatment is painless.
Before your radiotherapy begins, you will need to have an appointment to plan it. This is often called a simulation appointment, because you will be put in the exact position needed for your treatment.
A radiation therapist will take measurements of your body, as well as doing an x-ray or CT scan, to work out the precise area to be treated. For spinal cord tumours, some small tattoos may be marked on your skin to indicate the treatment area. For brain tumours, a face mask – also called a cast – is made to keep the head in position. It is a tight-fitting mesh, but you will only wear it for about 10 minutes at a time. However, let the radiation therapist know if wearing the mask makes you uncomfortable.
Radiotherapy treatment is usually given once daily, from Monday to Friday, for several weeks. However, the course of your treatment will depend on the size and type of the tumour.
Chemotherapy for brain and spinal cord tumours
Chemotherapy is the use of drugs to treat cancer. Generally, chemotherapy drugs travel through the bloodstream and damage or destroy rapidly dividing cells such as cancer cells, while causing the least possible damage to healthy cells. Healthy fast-growing cells, such as your bone marrow, may also be affected, causing side effects.
However, it can be difficult to treat brain tumours with chemotherapy drugs because the body has a protection system called the blood-brain barrier. This guards the brain from substances circulating in the blood, such as germs or chemicals, that could harm it. Only certain drugs can get through this barrier.
You may be given chemotherapy by taking an oral capsule or through a drip inserted into your vein (intravenously). Each treatment session is usually followed by a rest period of a few weeks.
Some patients who have a craniotomy have small, dissolvable chemotherapy wafers inserted into their brain during surgery. The wafers release drugs into the brain over a couple of weeks. As the drug is placed directly at the tumour site, it doesn’t affect other areas of the body and so reduces the chance of side effects.
Chemotherapy is often combined with radiotherapy for the treatment of glioblastomas (grade 4 tumours). This combination improves outcomes, compared with radiotherapy alone.
Breast cancer occurs when the cells lining the breast ducts or lobules grow abnormally and out of control. A tumour can form in the ducts or lobules of the breast.
When the cells that look like breast cancer are still confined to the ducts or lobules of the breast, it is called pre-invasive breast cancer.
Most breast cancers are found when they are invasive. This means the cancer has spread outside the ducts or lobules of the breast into surrounding tissue.
You may notice a change in your breast or your doctor may find an unusual breast change during a clinical breast examination. Signs to look for include:
Tests to diagnose breast cancer
Several tests are usually used to find out if your breast change is due to breast cancer.
Physical examination
Your doctor will feel your breasts and the lymph nodes under your arms. They will also take a full medical history and ask about your family history.
Mammogram
A mammogram is a low-dose x-ray of the breast tissue. This scan can find changes that are too small to be felt through a physical examination.
Your breast is pressed between two x-ray plates, which spread the breast tissue out so clear pictures can be taken. Both breasts are checked. Many women find this procedure uncomfortable, but it’s over in about 20 seconds.
Sometimes, the doctor will feel a lump that is not shown on a mammogram and other tests will need to be done.
Ultrasound
An ultrasound is a painless scan that uses soundwaves to create a picture of your body. A gel is spread on your breast and a small device called a transducer is moved over the area.
This sends out soundwaves that echo when they meet something dense, like an organ or tumour. A computer creates a picture from these echoes. The scan takes about 15-20 minutes.
Biopsy
Your doctor will suggest a biopsy if an abnormal or unusual area of tissue is found in your breast. During a biopsy, a small amount of tissue is removed from your breast. A pathologist examines the removed tissue and checks for cancer cells under a microscope. You may need to have more than one biopsy.
Surgery
Surgery for breast cancer will involve one of the following:
In most cases, breast surgery also involves removing one or more lymph nodes from the armpit.
It can be difficult to decide which type of surgery to have. Some women do not want to have their whole breast removed. Research has shown that breast conserving surgery, with sentinel node biopsy followed by radiotherapy, is as effective as mastectomy for most women with early breast cancer.
The operations have different benefits, side effects and risks. Talk to your doctor or breast care nurse about the best option.
Removing lymph nodes
Lymph nodes (glands) are found throughout the body, including the armpit. They are small, bean-shaped collections of lymph cells that protect the body against disease and infection. The lymph nodes are part of the lymphatic system.
The lymph nodes in the armpit are often the first place breast cancer cells spread to outside the breast. To check if breast cancer has spread to the lymph nodes, they are removed. There are two ways of removing the lymph nodes.
Sentinel node biopsy
The sentinel node is the first lymph node that breast cancer cells may spread to outside the breast.
There can be more than one sentinel node. Usually it is in the armpit but it can also be found near the breast bone (sternum).
Removing only the sentinel node/s will cause fewer side effects than axillary surgery. A small amount of radioactive substance is injected around the cancer before surgery. A scan is taken to show which node the substance has travelled to. During surgery, a blue dye is injected around the cancer in your breast. The dye moves into the lymphatic vessels. The nodes that become blue or radioactive first are known as the sentinel nodes, and the surgeon will remove only those nodes so they can be tested for cancer cells.
If the sentinel nodes are clear of cancer cells, no further surgery is needed. If the sentinel nodes contain cancer cells, axillary surgery will be needed.
Axillary (lymph node) surgery
This may be done at the same time as your breast surgery or as a separate operation. The doctor will remove the least possible amount of your lymph nodes.
Lymph nodes are sent to a pathologist for examination. The pathologist will provide a report that shows how many nodes were removed and how many contain cancer cells. For instance, if 17 nodes were removed and four contained cancer cells, the report will read: 4/17.
Results help your doctor recommend further treatment.
Physical side effects
Chemotherapy for breast cancer
Chemotherapy uses drugs to kill or slow the growth of cancer cells. Chemotherapy may be used:
There are several different types of chemotherapy drugs used to treat breast cancer. The drug combination you are given will depend on the type of breast cancer you have and what other treatments you are having. Common drugs include cyclophosphamide, docetaxel, doxorubicin, carboplatin and fluorouracil. Your medical team may also refer to the drugs by their brand (trade) names.
Chemotherapy is usually given through a vein (intravenously). You will have about 4-6 chemotherapy sessions every 2-3 weeks over several months. You usually will be treated as a day patient but occasionally an overnight stay may be recommended. The recovery time after each treatment session is called a cycle. This gives your body time to recover before the next session.
Radiotherapy for breast cancer
Radiotherapy uses high-energy x-rays to kill cancer cells or stop them growing.
This treatment is recommended after breast conserving surgery to help destroy any cancer cells left in the breast and reduce the risk of the cancer coming back. It is also occasionally given after a mastectomy.
Treatment is carefully planned to do as little harm as possible to your normal body tissues. Before you start treatment, you will have a planning session at the radiotherapy centre. During this visit, x-rays are taken to pinpoint the area to be treated and marks will be put on your skin so that the radiation oncologist treats the same area each time. These marks are small dots and may be temporary or permanent (tattoos).
Once treatment starts, you will probably have radiotherapy once a day from Monday to Friday for 5-6 weeks. Usually you can have outpatient treatment and go to the radiotherapy centre each day.
Each radiotherapy session will be in a treatment room. Although you will only get radiation for 1-5 minutes, you might be in the treatment room for 10-30 minutes. Most of the time is spent positioning you and the treatment machine.
You will lie on a table under the radiotherapy machine. The radiation therapist will leave the room then turn on the machine, but you can talk to staff through an intercom. Radiotherapy is not painful but you need to lie still while the treatment is given.
Side effects
Radiotherapy may cause the following side effects:
Radiotherapy to the breast does not cause hair loss. It also does not make you radioactive – it is safe to interact with your friends and family.
Side effects
The side effects caused by chemotherapy depend on the drugs used. Most side effects are temporary and steps can often be taken to prevent or reduce them.
Side effects may include feeling sick (nauseous), vomiting, tiredness, mouth ulcers or weight changes. Most people who have chemotherapy lose their head and body hair.
Some women’s periods become irregular or stop during chemotherapy but return to normal after treatment. For others, chemotherapy may cause periods to stop permanently (menopause).
Hormone therapy for breast cancer
Hormone therapy, also called endocrine therapy, is for people who have ER+ hormone receptors on their breast cancer cells. The aim of hormone therapy is to slow or stop the growth of hormone receptor positive cancer cells.
Ask your doctor if hormone therapy is suitable for you. This will depend on your age, the type of breast cancer you have and whether you have reached menopause.
Bowel cancer is cancer in any part of the large bowel (colon or rectum). It is sometimes also known as colorectal cancer.
Bowel cancer grows from the inner lining of the bowel (mucosa). It may develop from growths on the bowel wall called polyps. Polyps are usually harmless (benign), but they may become cancerous (malignant) over time. Malignant polyps may be small or large, flat or mushroom-shaped.
If untreated, bowel cancer can grow locally into the deeper layers of the bowel wall. It can spread from there to the lymph nodes (glands). These small, bean-shaped masses are part of the body’s lymphatic system. If the cancer advances further, it can spread to other organs, such as the liver or lungs (metastasis).
In most cases, it develops fairly slowly and stays in the bowel for months or years before spreading.
In its early stages, bowel cancer often has no symptoms. However, some people may experience the following:
Not everyone who has these symptoms has bowel cancer. Other medical conditions, such as haemorrhoids or tears in anal tissue, and some foods or medications, can also cause these changes.
If you have any of the above symptoms for more than two weeks, see your doctor for a check-up.
Your GP will examine you and refer you to a specialist for further tests. The tests you have depend on your specific situation and may include:
Some tests may be repeated during or after treatment to check how well the treatment is working.
Radiotherapy for bowel cancer
Radiotherapy uses high-energy x-rays or electron beams (radiation) to kill or damage cancer cells. The radiation is targeted to cancer sites in your body, and treatment is carefully planned to do as little harm as possible to your normal body tissue around the cancer.
Radiotherapy is often part of the treatment for rectal cancer. It can also be given:
During treatment, you will lie under a machine that delivers x-ray beams to the treatment area. Each treatment only takes a few minutes once it has started, but setting up the machine and seeing the radiation oncologist may take more time.
If radiotherapy is given along with chemotherapy for rectal cancer, you will probably have it once a day, Monday to Friday, for about 5–7 weeks. You may have a shorter course of radiotherapy if it is given by itself. The number of treatments you have depends on your radiation oncologist’s recommendation.
Side effects
Radiotherapy can cause temporary and permanent side effects. Side effects of radiotherapy may include:
People react to treatment differently, so some people may have few side effects while others have many. Tell your treatment team about the side effects you have so they can give you advice about how to manage them.
Chemotherapy for bowel cancer
Chemotherapy is the treatment of cancer with anti-cancer (cytotoxic) drugs. The aim of chemotherapy is to kill cancer cells while doing the least possible damage to healthy cells. If the cancer is contained inside the bowel, surgery is usually the only treatment needed and chemotherapy is not used.
Chemotherapy may be used for the following reasons:
If you have chemotherapy after surgery, you will probably have 6–8 weeks to recover. You will start chemotherapy when your wounds are healed and you are strong enough.
Chemotherapy drugs are usually injected into a vein (given intravenously) or supplied in tablet form. Some people have a small medical appliance called a port-a-cath or catheter placed beneath their skin through which they receive chemotherapy. You will probably have sessions of chemotherapy over several weeks or months. Your medical team will work out your treatment schedule.Your doctor may advise you to use contraception during chemotherapy, due to the effects of the drugs.
Side effects
Some chemotherapy drugs can cause side effects. The side effects depend on the drugs used and the dosage levels. The most common side effects include:
People react to treatment differently – some people may have few side effects while others have many. Most side effects are temporary, and there are ways to prevent or reduce them. Your doctor may prescribe medication to manage the side effects, arrange a break in your treatment, or change your treatment.
Surgery for rectal and anal cancers
There are different types of surgery for bowel cancer. The aim of surgery is to remove all the cancer and nearby lymph nodes.
Cervical cancer is a malignant tumour in the tissues of the cervix. It most commonly begins in an area called the transformation zone, which is where two types of cells meet.
At diagnosis, the cancer is often within the cervix, but it may have spread to tissues around the cervix (e.g. the vagina) or to other parts of the body.
The early stages of cervical cancer usually have no symptoms. The only way to know if there are abnormal cells in the cervix, which may develop into cervical cancer, is to have a Pap smear.
If symptoms are present, they usually include:
Your cancer may have been diagnosed following investigations for an abnormal pap smear or following investigations into abnormal bleeding or other symptoms. Further tests are required to determine the stage of the cancer.
Surgery
Surgery is common for small tumours found only within the cervix. The extent of the cancer in the cervix will determine the type of surgery needed:
Unless your cervical cancer is a very early stage you will require a pelvic lymphadenectomy which is the removal of lymph nodes in the pelvis This may cause leg swelling (lymphoedema) particularly if surgery occurs in combination with radiotherapy. For this reason investigations such as PET and MRI scan are carried out to assess whether the lymph nodes have cancer in them. If the lymph nodes appear to be affected chemoradiation will be given even for early cancers and surgery will not be required.
Radiotherapy for cervical cancer
Your doctor will advise you on the best treatment for the cancer. This will depend on the results of your tests, the location of the cancer and whether it has spread, your age and general health.
The most common treatments for cervical cancer are surgery or a combination of chemotherapy and radiotherapy.
Radiotherapy uses x-rays to kill cancer cells or injure them so they cannot multiply. The radiation is targeted at cancer sites and treatment is carefully planned to do as little harm as possible to the healthy body tissues.
Radiotherapy is usually given if you are not well enough for a major operation or if the cancer has spread into the tissues or lymph nodes surrounding the cervix. It may also be used after surgery or in combination with chemotherapy.
Side effects
The side effects of chemotherapy vary according to the drugs used. You may experience nausea or vomiting, feel tired, or lose some hair from your body or head. Some women’s periods stop for a while and they may experience premature menopause.
While you’re having treatment, the chemotherapy may also reduce the number of blood cells in your body. Depending on the type of blood cells affected, you may feel very tired and be more prone to infections such as colds and flu.
Most side effects are temporary and there are ways to prevent or reduce them. Tell your medical team if you experience side effects.
Ovarian cancer is a malignant tumour in one or both ovaries. Some cases of ovarian cancer may form in the fallopian tube and spread to the ovary.
There are many types of ovarian cancer. The three most common types are:
Epithelial ovarian cancers
The majority of women with ovarian cancer have cancer that starts in the surface of the ovary (epithelium). Types of epithelial ovarian cancer include serous, clear cell, endometrioid and mucinous cancers.
Germ cell ovarian cancers
About 4% of women have these rare types of cancer, which start in the egg-producing cells. Germ cell cancers usually affect women aged around 35.
Sex-cord stromal cancers
Rare tumours may develop in the cells that produce female hormones. These cancers can occur at any age, and may produce extra hormones, such as oestrogen. They generally respond very well to treatment.
Some women (usually younger women) are diagnosed with a borderline tumour. This is not considered to be cancer because, although it can spread, it does not invade other organs. For this reason borderline tumours are called low malignant potential tumours and usually have a good prognosis.
Ovarian cancer may not cause any symptoms in its early stages, or it may cause only vague ones that are hard to recognise. If symptoms occur, they may include:
If these symptoms are new for you or continue over a four-week period, make an appointment with your general practitioner (GP). Having these symptoms does not necessarily mean you have cancer, but it is best to have a check-up
Most ovarian cancer tumours are present for some time before they are discovered. Sometimes ovarian cancer is found unexpectedly during an operation such as a hysterectomy.
The Pap test does not detect ovarian cancer, but it may show if cancer cells have spread to the cervix.
Surgery
Treatment for ovarian cancer depends on what type of cancer you have, the stage, your general health and fitness, your doctors’ recommendations and your wishes.
Your gynaecological oncologist will talk to you about the most appropriate type of surgery. An exploratory laparotomy is usually recommended if ovarian cancer is suspected. In this operation, the doctor makes a long, vertical cut from your bellybutton to your pubic bone hairline while you are under a general anaesthetic.
The surgeon will take tissue (biopsy) and fluid samples from the abdomen. While still in theatre, the tissue samples are sent to a specialist called a pathologist who examines them for signs of cancer. This is called a frozen section analysis. If the pathologist confirms that cancer is present, the surgeon will continue the operation.
If there is obvious spread of cancer, the surgeon will remove as much of the cancer as is possible. This is called surgical debulking. Surgical debulking allows chemotherapy treatment to be more effective.
Radiotherapy uses x-rays to kill or damage cancer cells and reduce their activity. It is used less often than chemotherapy. The main use for radiotherapy is to ease symptoms or problems which are not responding to chemotherapy or when chemotherapy can no longer be given.
If the cancer has spread, you will usually receive radiotherapy to the pelvis, or other parts of your body.
During radiotherapy you will be in a room and lie on an examination couch or table. A radiotherapy machine will be moved around you depending on the body part being treated. The radiation therapist will position you and the machine and then leave the room during treatment.
You will not feel anything during treatment, which will only take a few minutes each time. You may be in the room for a total of about 10–20 minutes for each appointment.
The number of radiotherapy sessions you have will depend on the type and size of the cancer. You may have treatment for a week or daily outpatient treatment for several weeks. Your doctor will explain the treatment schedule and the possible side effects.
Side effects
The side effects of radiotherapy depend on the strength of the dose and the part of your body that is treated. You may experience the following:
Chemotherapy is the treatment of cancer with anti-cancer (cytotoxic) drugs. The aim is to destroy cancer cells while causing the least possible damage to normal, healthy cells.
Although surgery may have removed most of the ovarian cancer, there may still be some cancer cells in the body. For this reason, chemotherapy is usually given soon after an operation.
Women with early stage epithelial ovarian cancer or borderline tumours may not need chemotherapy.
Women with epithelial ovarian cancer that has spread outside the ovaries usually receive a combination of two chemotherapy drugs. However, a single chemotherapy drug may be prescribed for frail or elderly women, or if there are other particular medical concerns.
Chemotherapy is usually given through an intravenous drip. Some people have a small medical appliance called a port-a-cath or catheter placed beneath their skin through which they receive chemotherapy.
Current standard treatment after surgery (adjuvant chemotherapy) is six treatments, given every 3–4 weeks over 5–6 months. Each chemotherapy treatment is called a cycle. However, some centres give chemotherapy in weekly doses and treatment varies for different women. Ask your doctor about the treatment plan recommended for you.
Cancer of the uterus (also called uterine cancer) is a cancer of the female reproductive system. It begins from abnormal cells in the lining of the uterus (endometrium) or the muscle tissue of the uterus (myometrium).
Symptoms
Your doctor will advise you on the best treatment for the cancer. This will depend on the results of your tests, where the cancer is, if it has spread, your age and your general health.
The main treatment for cancer of the uterus is surgery because it is often diagnosed at an early stage before it has spread. This means that for many women, surgery will be the only treatment they need.
If the cancer has spread beyond the uterus, radiotherapy, hormone treatment or chemotherapy may also be used.
Radiotherapy for cancer of the uterus
Radiotherapy uses x-rays to kill cancer cells or injure them so they cannot multiply. The radiation can be targeted at cancer sites in your body. Treatment is carefully planned to do as little harm as possible to your healthy body tissues.
Radiotherapy may be recommended if you are not well enough for a major operation. It is also commonly used as an additional treatment to reduce the chance of the disease coming back. This is called adjuvant therapy.
Chemotherapy for cancer of the uterus
Chemotherapy is the use of cytotoxic drugs, which kill or slow the growth of cancer cells. The aim is to destroy cancer cells while causing the least possible damage to healthy cells. Chemotherapy may be used:
Chemotherapy is usually given by injecting the drugs into a vein (intravenously). You may need to stay in the hospital overnight or you may be treated as an outpatient. You will have a number of treatments, sometimes up to six, every 3–4 weeks over several months. Your doctor will talk to you about how long your treatment will last.
Acute leukaemia appears suddenly and develops quickly. It occurs when immature white blood cells (blast cells) grow out of control and continue to divide but never mature into normal cells.
The abnormal blast cells are known as leukaemia cells. Because they are immature and abnormal, leukaemia cells do not carry out the usual function of white blood cells. They also crowd out the normal white blood cells, which leads to an increased risk of infections.
When the bone marrow fills with leukaemia cells, there is little room for healthy red cells and platelets to be produced. This causes a variety of health problems.
There are two types of acute leukaemia, depending on what type of white blood cell is involved:
ALL is a leukaemia involving lymphoid blast cells, which are known as lymphoblasts. ALL is also sometimes called acute lymphatic leukaemia.
AML is a leukaemia involving myeloid blast cells, also called myeloblasts.
Other types of leukaemia
There are several different types of leukaemia. All leukaemias start in the bone marrow and affect white blood cell production. They are grouped depending on how quickly the disease develops and which type of white blood cell is affected (lymphoid or myeloid).
The main symptoms are caused by the continually increasing number of leukaemia cells in the bone marrow, which reduces the number of normal blood cells.
The main signs include:
An initial blood test will show if leukaemia cells are present or if the levels of blood cells are different to those of a healthy person. Other tests will confirm a diagnosis and will determine what type of leukaemia you have.
Treatment usually begins as soon as you have been diagnosed and will depend on what type of acute leukaemia you have.
Radiotherapy for acute leukaemia
Uses x-rays to destroy cancer cells or injure them so they cannot multiply. It is used for people with acute lymphoblastic leukaemia and, less commonly, acute myeloid leukaemia. It is usually directed at the brain and spine. It is sometimes given to the whole body in preparation for a transplant. Your radiation oncologist and haematologist will discuss the type of radiotherapy and the number of treatments you need.
Chemotherapy for acute leukaemia
Chemotherapy uses anti-cancer drugs to kill cancer cells while doing the least possible damage to healthy cells.
It is usually given by injection into a vein (intravenously). Sometimes it is given in tablet form or as an injection into the spine during a lumbar puncture.
Chemotherapy for acute leukaemia is given in two or three stages: induction, consolidation and maintenance. Only people with acute lymphoblastic leukaemia and a rare type of acute myeloid leukaemia are given maintenance treatment.
Head and neck cancer occurs when malignant tumours grow in any of the tissue in the head or neck. Not all tumours in the head and neck are malignant, but benign and malignant tumours are treated in a similar way.
Oral Cancer
Pharyngeal cancer symptoms
Laryngeal cancer symptoms
Nasal and para nasal symptoms
If you have symptoms that could be due to a head or neck cancer, your general practitioner (GP) can do initial tests but will then refer you to a specialist for further tests. Depending on your symptoms, you may have one or more of the following tests, which include physical and visual examinations, tissue sampling (biopsy) and imaging tests. You will probably also have blood tests.
Surgery for head and neck cancers
The aim of surgery is to remove cancerous tissue and preserve the functions of the head and neck, such as breathing, swallowing and speech, as much as possible. There are different ways surgeons can operate.
The surgeons may only need to cut out a small area, which will include an area of healthy tissue around the tumour called a margin. If the operation is small, the healing is usually fast, with few long-term side effects.
For more advanced cancer, an operation will be more extensive and will cause longer-lasting or permanent side effects.
Your doctors will discuss whether surgery is an option for you, and the best type of operation for you.
Radiotherapy for head and neck cancers
Radiotherapy is the use of high-energy x-rays or electrons to kill or damage cancer cells so they can no longer grow and multiply. It can be used alone or with other treatment. Radiotherapy can be given in different ways, either externally or internally.
Before radiotherapy begins, the staff will see you to plan the treatment. You will have scans and you may need to be fitted for a mask to wear so that the same location is treated at each session. You will wear the mask for up to an hour in the planning session, but only for 5-40 minutes during treatment, depending on the location of the cancer. You can see and breathe through the mask.
Chemotherapy for head and neck cancers
Chemotherapy is the treatment of cancer with anti-cancer (cytotoxic) drugs and newer “˜targeted’ agents. The aim of chemotherapy is to kill cancer cells while doing the least possible damage to healthy cells. It can be given for different reasons:
You will probably receive chemotherapy by injection into a vein (intravenously) at treatment sessions over several weeks.
Thyroid cancer occurs when the cells of the thyroid gland grow and divide in a disorderly way.
The four main types are:
Thyroid cancer usually develops slowly, without many obvious signs or symptoms. However, some people experience one or more of the following:
Having a painless lump in the neck is the most common sign. However, thyroid lumps, known as nodules, are relatively common and most are benign. In about 90% of cases, a thyroid nodule is a symptom of a goitre (a benign enlarged thyroid gland) or another condition affecting the head or neck.
The type of treatment you have depends on:
Surgery for thyroid cancer
Treatment for thyroid cancer usually includes surgery, thyroid hormone replacement therapy and radioactive iodine treatment. Some people also need external radiotherapy or chemotherapy. Most people receive a combination of treatments.
Surgery is the most common treatment for thyroid cancer.
External radiotherapy for thyroid cancer
External radiotherapy is the use of high-energy x-rays or electron beams to kill or damage cancer cells.
Radiotherapy may be given after surgery, or as an additional treatment to radioactive iodine treatment if the cancer has spread to lymph nodes in the neck. It is commonly used to treat medullary or anaplastic thyroid cancer because radioactive iodine treatment is usually less effective for these types of cancers.
You will not be radioactive after external radiotherapy treatment, so it is safe to be with other people.
Before the treatment starts, you will have a planning (simulation) session. Your doctor will take CT scans to determine the precise area to be treated, and may make small marks or tattoos on your skin. This ensures the same part of your body is targeted during each treatment session.
You may be fitted for a mask to wear during treatment. This will help make sure that you don’t move and the radiation beams always treat the correct areas of your neck.
Radiotherapy is usually given five days a week over several weeks. Treatment sessions usually take about 10 minutes. During this time, you will be able to see and breathe through the mask. Let your doctor know if you are afraid of confined spaces (claustrophobic).
Chemotherapy for thyroid cancer
Chemotherapy is the use of drugs to kill or slow the growth of cancer cells. It is sometimes used to treat advanced thyroid cancer that is not responding to radioactive iodine treatment.
The drugs are usually given by injection into a vein (intravenously). You will probably have several treatment sessions over a few weeks – your medical team will determine the schedule.
Lung cancer is a malignant tumour in the tissue of one or both lungs. There are several types of lung cancer, which are classified according to the type of cell affected: non-small cell lung cancer; small cell lung cancer; and mesothelioma.
The main symptoms of lung cancer are:
Lung cancer is often discovered when it is advanced. A person may have experienced symptoms such as fatigue, weight loss, hoarseness or wheezing, difficulty swallowing, or abdominal and joint pain.
Having any one of these symptoms does not necessarily mean that you have cancer. Some of these symptoms may be caused by other conditions or by the side effects of smoking. Talk to your doctor to have your symptoms checked.
Lung cancer is sometimes detected during routine tests for other problems and if so is more likely to be in an early stage
of development.
If lung cancer is suspected, a number of tests will be done to help make a diagnosis.
Surgery for lung cancer
Surgical removal of a tumour offers the best chance of a cure for patients who have early-stage cancer. The surgeon, who is part of the multidisciplinary team, will determine if the cancer is confined to your lung, assess your general wellbeing and fitness for an operation, and assess your breathing capacity.
Patients must cease smoking for a minimum of four weeks before any surgery will be performed.
Radiotherapy for lung cancer
Radiotherapy treats cancer by using x-ray beams to kill cancer cells. Radiotherapy is offered when lung cancer cannot be managed by surgery and has not spread outside the chest. Radiotherapy can also be used to treat cancer that has spread to the lymph nodes. This may stop the cancer from spreading further or from returning later. It is often given together with chemotherapy if the intention is to cure the cancer.
It can also be used:
Chemotherapy for lung cancer
Chemotherapy is the treatment of cancer with anti-cancer (cytotoxic) drugs. The aim of chemotherapy is to kill cancer cells while doing the least possible damage to healthy cells.
Chemotherapy is commonly given to patients whose cancer is large or has spread outside the lungs. It may be given:
Generally, chemotherapy is administered intravenously through a drip or a plastic catheter (tube) inserted into a vein in your arm, hand or chest. Some types of chemotherapy are given orally (that is in tablet form).
Chemotherapy is given in cycles that typically last three weeks each. Intravenous chemotherapy may be given for a few days. The rest of the time is a break from treatment. The number of treatments you have will depend on the type of lung cancer you have and how well your body is handling the side effects.
Pancreatic cancer occurs when malignant cells develop in a part of the pancreas. This may affect the normal functioning of the pancreas, including the way the exocrine or endocrine glands work.
About 70% of pancreatic cancers are located in the head of the pancreas. This can block the common bile duct, which will decrease the flow of bile and cause a build-up of bile pigment in the blood. This is known as jaundice.
Early stages of pancreatic cancer rarely cause symptoms. Symptoms also may be unnoticed until the cancer is large enough to affect nearby organs.
Symptoms of pancreatic cancer may include:
Symptoms of pancreatic cancer are also common to other conditions. See your doctor if you experience any of these symptoms.
To confirm the diagnosis of pancreatic cancer, your doctor will take a full medical history and you will have several tests. Some tests will help the doctor determine if cancer has spread to other parts of your body. This is called staging.
Although research has improved outcomes for many people, pancreatic cancer can be difficult to treat. Surgery in combination with chemotherapy, and possibly radiotherapy, is the most effective treatment.
The type of treatment you have will depend on:
Types of Surgery
Surgery may also be used to relieve symptoms, such as intestinal (bowel) obstruction or jaundice. Jaundice is a condition in which the skin and the eyes turn a yellow colour as bile builds up in the blood.
Radiotherapy
Radiotherapy treats cancer by using x-rays to kill cancer cells or injure them so they cannot multiply. These x-rays can be targeted at cancer sites in your body.
Radiotherapy may be used:
Treatment is usually given Monday to Friday, for up to five weeks. It is painless and each session takes a few minutes. Treatment is planned to do as little harm as possible to your normal body tissues.
Prostate cancer develops when abnormal cells in the prostate gland grow more quickly than in a normal prostate, forming a malignant tumour.
Most prostate cancers grow slower than other types of cancer.
Early (or localised) prostate cancer means cancer cells have grown, but they have not spread beyond the prostate. Some prostate cancers may spread to other parts of the body, such as the bones and lymph nodes. This is called advanced prostate cancer.
Early prostate cancer rarely causes symptoms. This is because the cancer usually grows in the outer part of the gland and is not large enough to put pressure on the urethra. If the cancer grows and spreads beyond the prostate (advanced or metastatic cancer), it may cause:
These symptoms are common to other conditions, including benign prostate enlargement, and may not be a sign of advanced prostate cancer. If you are concerned and/or are experiencing any of these symptoms, speak to your doctor.
External radiotherapy for prostate cancer
External beam radiotherapy uses high-energy x-rays to kill cancer cells or injure them so they cannot multiply. Radiotherapy is usually considered if you have early cancer and are otherwise in good general health. It may be used instead of surgery or in combination with surgery.
Before your treatment session, a radiotherapy technician will set up the machine. You may see the radiation oncologist and have blood tests. Preparation usually takes about 1 hour. During the treatment session, you will lie on an examination table under the machine that aims at your prostate. Treatment is painless and each session usually takes about 15 minutes.
Treatment is planned to ensure as little harm as possible to the normal tissue and organs surrounding the prostate. Modern machines are more accurate and can limit radiation exposure to surrounding healthy tissue. Usually, you will have radiotherapy treatment every week day for up to eight weeks. Some newer machines have shortened treatments to five sessions.
You can have radiotherapy as an outpatient and go to the treatment centre or hospital each day for your treatment session. Many men continue to work during the course of radiotherapy.
Side effects of radiotherapy
You may have some of the following side effects. Other side effects such as tiredness, bowel and bladder problems are becoming less common due to machines that are better at targeting the tumour.
Radical prostatectomy
Your doctor may suggest surgery if you have early prostate cancer, are fit enough for surgery and expect to live longer than 10 years. The procedure is called a radical prostatectomy, which is the removal of the prostate gland, part of the urethra and the seminal vesicles, glands located close by that store semen. For more aggressive cancer, the adjacent lymph glands may also be removed (pelvic lymph node dissection).
Radical prostatectomy may be performed using different surgery techniques (open, laparoscopic or robotic-assisted). Whichever approach is used, a radical prostatectomy is major surgery. Men usually return to normal activities within 2–6 weeks.
Androgen deprivation therapy
Prostate cancer needs the male hormone testosterone to grow. Slowing the production of testosterone may slow the growth of the cancer or shrink it. This is called androgen deprivation therapy (ADT) or hormone therapy.
ADT is normally used when the prostate cancer cells have spread beyond the prostate. It will not cure the cancer but can keep it under control for many months or years. It can also help with symptoms such as pain caused by the cancer spreading, and make the symptoms of cancer temporarily reduce or disappear (temporary remission).
The timing of ADT may vary. It may be given before radiotherapy or together with radiotherapy and may be continued after radiotherapy to increase the effectiveness of treatment.
Information extracted from the Cancer Council NSW website and reproduced with permission. © Cancer Council NSW 2013
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