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So, you've been told you have cancer...Click ---> Dont' Panic | Talk to your Doctor | Establishing the Diagnosis | Staging | Treatment | Follow Up
Don’t Panic!Well, the first thing to do is not panic! There are many things that can be done nowadays for people who have developed a cancer. Many cancers are being found earlier and earlier and this is a great thing as early cancers are much more easily treated with a higher chance of overall success.
You are not alone in going though the experience. On average one in four people get cancer during their lifetime. This means that the cancer departments near you are aware of the problem and are geared up to cope for you. You will have specific problems that individualise your cancer and this is where we try and ensure that “standard” techniques are altered and tailored to your situation.
Talk to your DoctorTalk to your Local Doctor; he or she is essential to your care. They will then arrange to send you to a specialist who will establish what is happening and talk to you about the treatment for your problem. Your local Doctor should be the first point of contact and will be keen to ensure that you receive the best of care.
Establishing the diagnosis
The first step to treating a cancer is called “Establishing the diagnosis”. This will probably have already happened to you or your relation if you are accessing this website. Establishing that there is a cancer present is the most basic of steps but it tells both you, and us, that there is something that needs to be dealt with. This will usually involve one or more X-rays or CTs, and probably some kind of biopsy (where some cells are looked at under a microscope).
StagingThe second step to treating a cancer is called “Staging”. Staging is where tests are carried out to assess the extent of the tumour, ie how large it is, what it is adjacent to, and if it has moved to another site. (Think of it like this: if you should decide to go and put down wall to wall carpet in your living-room, the first thing you are going to do is measure the size of the room!)
These staging tests may include blood tests which will look at kidney, liver and bone marrow function, and may also include tests called “Tumour Markers”.Tumour markers are tell-tale signs that some cancers will put into the blood stream. If your cancer has a reputation for producing such tumour markers then these will be checked as part of the staging to see if they might be present. If they are, then they can be used in the long term to monitor the progress of the cancer.
The type of cancer is important to establish and so a biopsy will be taken. A biopsy is where a sample of the cancer is removed for examination under a microscope. This will tell us what variant of cancer we are dealing with and gives us an indication in some cases as to what treatment options will be better for treating it. A biopsy may be done with a “skinny needle” or may be complete removal of the tumour. There are many different reasons why one should be better than another and the appropriate choice will be made for you. It may be that the initial tests done were with a “skinny needle”, more information is required, and so further biopsies may be taken.
Another group of staging investigations include tests that obtain pictures of the cancer. These include X-rays, CT scans, MRIs, PET scans, bone scans, ultrasounds, gallium or thallium scans and more. All of these are designed to look at the size and shape of the cancer, as well as trying to establish whether there is a single site or more than one place the cancer is in.
Not all of these tests will be necessary for your cancer. It is up to the treating Doctor to establish what staging investigations are appropriate and necessary but there will definitely be some of these.
Generally, there are 4 stages of cancer with stage 1 early, stage 2 reasonably early, stage 3 advanced but curable and stage 4 metastatic and rarely curable. Just because it is considered stage 4 and not curable does not mean that that person won’t live for many years with the diagnosis although the likelihood varies from cancer to cancer. The stage of the disease is determined by the extent of the cancer. Other factors are relevant, such as the grade of the disease (how aggressive it is) and the presence or absence of hormone receptors on the tumour cell.
TreatmentThe third step then is the treatment of the cancer. This will involve some form of treatment which will include any or all treatment options of surgery, radiotherapy, chemotherapy, immunotherapy or hormonal manipulation. What is used for you will depend entirely upon what choices are appropriate and will be explained to you in whatever depth and detail you want.
Follow UpAfter your cancer has been treated we usually embark on a program of routine follow-ups which go on for many years, getting less frequent as we get away from the time of diagnosis. This program is usually shared with your GP and your other treating specialists. It will include clinical examination and assessment and may include blood tests and imaging.