Chemotherapy & Radiotherapy
Cancer is one of the toughest battles many of us will have to face, whether it be fighting it ourselves or supporting a loved one through their journey. Luckily, there are treatments nowadays that are making it more and more possible to beat cancer, with the statistics showing some optimistic improvements:
- 50% of cancer patients in England and Wales survive for 10 or more years
- Cancer survival rate in the UK has doubled in the last 40 years: 24% to 50%
The largest contributing factors to these figures are the two most commonly used treatments to battle cancer: Chemotherapy and radiotherapy.
When first diagnosed with cancer, many people’s first thought is the dread of experiencing chemotherapy, as we all know some of the effects it can have – both physically and mentally. However, some patients may not have chemo at all, and instead be offered radiotherapy, a common yet less known treatment that patients may be wary of. In this article, we go into detail about both chemo and radiotherapy, how they may be similar, as well as how they differ.
Related Article: How to support someone with cancer
Chemotherapy
What is chemotherapy?
Chemotherapy is a common form of cancer treatment that uses anti-cancer drugs as part of the standardised chemotherapy regimen of receiving the medicine over a set period of time, and often over several cycles. Chemotherapy can be used with the aim of curing the cancer, controlling it, reversing it, or reducing symptoms.
When is chemotherapy used?
Chemotherapy can be used during any stage of cancer. It is used for curative reasons in the earlier stages when cancer has been found early and not yet metastasised, and is instead used to ‘control’ cancer in later stages when the cancer is terminal, although it won’t cure the patient, it reduces symptoms and to give them a better quality of life.
Chemotherapy can also be used for non-cancerous diseases, such as blood disorders and a variety of autoimmune diseases.
What are the different methods of chemotherapy?
There are various different methods of being given chemotherapy. This depends of the type of cancer, stage, where the cancer is, and the particular drug you are having, they include:
Intravenous
Intravenous chemotherapy is the most common way that chemo is given. This is when the patients has the medicine slowly given to them directly into their vein from a bag of fluid. It is a time consuming method, ranging from taking several hours to several days, and you’ll usually go to the hospital every few weeks, or weekly, to receive this method of treatment.
Oral
Chemotherapy can also be taken orally. Some may just need oral chemo but others also require intravenous treatment too. You’ll be prescribed a tablet form of chemo that you collect from your hospital. Your doctors or nurses will give you all the information you need about dosage and when to/not to take them.
Chemotherapy is an incredibly powerful treatment, needing to be strong enough to kill cancer cells. So although these little tablet may seem like any other prescribed pill, they are actually hazardous. You should touch them as little as possible, washing your hands regularly, or wear gloves when taking them.
Make sure that you take your chemo tablets as instructed, if you forget to take your tablets, do not take a double dose the following day or exceed the planned time.
Intramuscular
Your doctor may require you to have chemotherapy injected directly into your muscle – usually the thigh or buttock – so that your body absorbs the drug slower, making its effects last longer.
Learn more about the different methods of chemotherapy
What are the side effects of chemotherapy?
Everyone knows that chemotherapy can be more than unpleasant. The side effects that patients experience whilst on chemo depends on various factors. For starters, it depends on the patient, different bodies will react to chemo in different ways. But it’s also based on the type of chemotherapy, its strength, the way it is taken, and the cancer type. Below, we’ve listed some of the side effects experienced across the board of chemo types.
Tiredness
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One of the most common side effects of chemotherapy is tiredness. A few days following the treatment, you’ll likely feel like you have no energy and just want to sleep all day.
Nausea and vomiting
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Another common effect of chemo is feeling sick and generally unwell. This can range from feeling slightly ill to vomiting regularly. Your care team can provide you with anti-sickness medicine to help.
Hair loss
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Possibly one the most feared side effects of chemotherapy is hair loss. Although not guaranteed with every patient, it is a fairly common side effect. It could just be a slight thinning of your hair, but can also be a complete loss of hair on your body.
Hair loss can be an upsetting and distressing side effect to experience, as many people often see it as the physical image of a ‘cancer patient’. Luckily, there is support for you if you experience hair loss.
Infection
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As mentioned before, chemotherapy is a very powerful medicine, with its mission to kill cancer cells, however with that it can kill and damage other cells, affecting your immune system. This makes it harder for your body to fight infection, so it’s a good idea to take extra care to protect yourself.
Anaemia
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As well as damaging your immune system, chemotherapy can also lower the amount of red blood cells carrying oxygen around your body. A lack of red blood cells can lead to anaemia.
Bruising and bleeding
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Chemotherapy also reduces cells called platelets that help prevent bleeding when you injure yourself, meaning you may experience more bruising and bleeding, such as nosebleeds and bleeding gums, during treatment.
Loss of appetite
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Some people on chemotherapy may lose their appetite. Food may also taste different from usual, putting you off your usual meals. It is important to remain hydrated and eat what you can during treatment. It can help to have smaller meals and regular healthy snacks, instead of the usual 3 large meals.
Insomnia
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Difficulty falling asleep is a fairly common side effect. This could be down to insomnia, or general anxiety, which is common to have during treatment.
Stress and anxiety
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Being diagnosed with cancer alone is enough to fill you with anxiety, so the added stress of psyching yourself up for the unknown of chemotherapy is enough to increase your risk of anxiety bringing on depression.
Related Article: Mental Health Help and Coping Mechanisms
Joining a support group, speaking to your care team, or getting support from charities such as Macmillan cancer support is a helpful way to feel less alone during such difficult times.
Macmillan: 0808 80800 00 | macmillan.org.uk
Is chemotherapy painful?
In terms of the process of taking chemotherapy, it usually is not painful. If you’re having the treatment via an injection, the initial insertion may cause some discomfort but nothing painful.
If you feel any major discomfort and pain whilst the chemo is being administered, get help from a nurse or doctor immediately, as it could be your body reacting badly or rejecting the treatment.
If you feel pain or discomfort at any other time, it may instead be the cancer itself. It is a good idea to contact your GP and care team if you experience any pain for a long period of time during treatment.
Radiotherapy
What is radiotherapy?
Radiotherapy, or radiation therapy, is another form of cancer treatment that is used to either cure or reduce the chance of cancer returning. This is usually done with x-rays, unlike chemotherapy, which uses medicine. Almost 50% of patients will have radiotherapy during their treatment. Radiotherapy has been used as a form of cancer treatment since 1953, unlike chemotherapy, which has been used as cancer treatment since 1919.
When is radiotherapy used?
Like chemotherapy, radiotherapy can be used at different stages of cancer for different reasons. For example, if the cancer is found early, radiotherapy can be used to destroy the cancer cells by changing the DNA makeup of the tumour, which makes it shrink. Later on, when the cancer may have metastasised, it can instead be used to alongside other treatments, such as chemo, or used before surgery to make the tumour easier to remove.
What are the different types of radiotherapy?
Patients can receive radiotherapy using different methods. Your doctor will recommend the best type for you depending on what they believe will be best for you.
External Radiotherapy
This is when a machine, most commonly called a linear accelerator, is used to carefully aim beams of radiation at the cancer. You won’t feel anything during treatment, but may feel side effects later on. This method of radiotherapy does not make you radioactive because it is passing through your body.
Radiotherapy Implants
Also called brachytherapy, this type of internal radiotherapy is where small pieces of radioactive material are put into your body, close to the cancer or where the cancer was before surgery. This method prevents much more healthy tissue from being damaged by the radiation.
Radioisotope Therapy
More similar to chemotherapy, this is when a radioactive liquid is given to you via injections, capsules, or as a drink.
Intrabeam Radiotherapy
Specific to breast cancer, this treatment involves having the radiation directly injected into the tumour. This usually takes place over a few days, and is not available at all NHS hospitals.
What are the side effects of radiotherapy?
The idea of being exposed to radiations understandably sounds rather scary. But like chemo, most of the side effects of radiotherapy will pass after treatment, or can be treated and prevented.
Radiotherapy methods that require implants or injections may require you to stay in hospital for a few days as a precaution because the radiation is within your body, as opposed to passing through like external radiotherapy.
Sore skin and mouth
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Radiation can have a similar effect on the skin as sun burn, making your skin sore and red, or darker and itchy. This usually starts 1 or 2 weeks after treatment begins. It is suggested that you use unperfumed soap and wash regularly, moisturise, and wear high-factor sunscreen.
Feeling tired
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One of the side effects that radiotherapy and chemotherapy share is fatigue. This can last for several weeks or months after treatment. It is recommended that you get plenty of rest, and make lifestyle changes to make sure you don’t overdo it. This may include asking your employer for time off or switch to part time.
Hair loss (In the area being treated)
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Hair loss during radiotherapy is usually less extreme than some cases of hair loss that occurs with chemo. Radiotherapy only causes hair loss in the area being treated, usually 2 or 3 weeks after treatment begins. High dosages of radiotherapy can cause permanent hair loss.
Nausea
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This side effect is more common when treatment is close to your stomach. You may feel sick for a short time during and after treatment, but anti-sickness medicine can help. Similar to chemotherapy, some people may lose their appetite because of sickness. To ensure you don’t lose weight, be sure to have regular, smaller meals instead of 3 large meals.
Stiff joints and muscles
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Stiff joints and muscles can occur in the area that is being treated with radiotherapy. Be sure to regularly stretch before and after sleep or long periods of not moving to help prevent stiffness. Exercising can also help reduce stiffness.
Is radiotherapy painful?
Radiotherapy is not painful and doesn’t hurt during the process. Like chemotherapy, some radiotherapy methods may require an injection and thus meaning you’ll feel a small prick. The only discomfort you may feel is from the side effects.
Some forms of radiotherapy, such as Brachytherapy (radiotherapy implants) may require anaesthesia or sedation, and is a painless procedure.
Chemoradiation
In some instances, you may have radiotherapy and chemotherapy at the same time. This is helpful with certain types of cancer, and can be used as both your main treatment or as a way to prevent cancer from returning.
The two forms of treatment work as a team to more effectively battle the cancer. To put it simply, chemotherapy weakens the cancer by making it more sensitive so that the radiotherapy is more effective at destroying it.
Combining the two treatments does however increase the chances of your experiencing worse side effects.
Other Cancer Treatments
Although chemotherapy and radiotherapy are some of the more common treatments for cancer, there are others methods that may be recommended to you. Some are likely to be used alongside, before, or after chemo/radiotherapy. Some others include:
Surgery
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In many cases, surgery will take place as a way to prevent the cancer from spreading. The surgery may be to remove the tumour itself, or to remove other body tissue to prevent further spreading.
Surgery isn’t suitable for all types of cancer, such as leukaemia or lymphoma.
Immunotherapy
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Whilst chemotherapy may weaken the immune system, there is also a treatment called immunotherapy which instead uses your immune system – which helps protect the body – to recognise and attack cancer cells. You can have this immunotherapy on its own or with other treatments.
Hormone Therapy
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With some cancers, such as breast and prostate cancer, using hormones to grow, there is treatment the helps to block or lower the amount of hormones.
Stem cell/bone marrow transplants
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By using stem cells, young cells found in the bone marrow (these can either be your own stem cells or a donor) these transplants help to start making both red and white blood cells that may have been killed during large dosages of chemo or full body radiotherapy.