Cancer - do you always have chemo/radiotherapy?

[ifonly4]

Do you always have chemo, radiotherapy or both when you have cancer?

My Uncle had lung cancer, had part of his lung removed in August and his understanding is he's got the all clear and they'll see him again in three months time. He's had no chemo or radiotherapy to destroy potential cells in his body and it's worrying me as two other people I know were diagnosed about the same time as my Uncle. One has already lost her fight despite chemo and radiotherapy and the other is having chemo before op, then radiotherapy after.

Not the same type of cancer but my FIL has bowel cancer removed by surgery. He had a short course of radiotherapy but no chemo. He’s been clear of it for 7 years now. It was all over and done with very quickly, although at the time of course it felt like a very long time indeed.

Or could it be possible that he was offered it but declined and doesn’t want to discuss it?

I'm interested in this too because DH has lung cancer. He is meeting the surgeon today to discuss an op to remove as much of the tumour as possible so they can diagnose what type of cancer it is - it's in an awkward position and the biopsy was inconclusive. The consultant has mentioned radiotherapy as a potential treatment after the tumour is removed, but has said if they can't get it all.out they may need to look at other options which I took to mean they would consider chemo.

Not necessarily. If the tumour is removed contained, and they may well have taken other biopsies and blood tests to check likelihood of spread. Sometimes the side effects of further treatment outweigh any potential benefits.

They'll weigh up all the options and take in to account age and fitness. It's all very complicated and individual.
Quite often it will just be surgery.
Some cancers are more likely to spread than others so chemo will be offered for these. It depends on the grade of the cancer, 1 is slow growing so wouldn't respond to chemo and grade 3 is fast growing and responds well.
So many variables.
I had breast cancer and my treatment was surgery and chemo due to my age (youngish) and the fact breast cancer likes to travel.

No, some breast cancer is literally just remove and then maybe adjuvant endocrine treatment. No need for RT or chemo

I had ovarian cancer removed by surgery, no need for any other treatment

My sister had thyroid cancer and had one dose of a specific type of radiotherapy they use for thyroid cancer. And I think tho am not 100% this was more to ascertain that all the thyroid had been successfully removed.

You also have to consider if your uncle has been told of the risks of chemo/radiotherapy and decided against it for his own reasons.

A relative of mine had lung cancer, diagnosed at stage 4. She was tested for a genetic mutation and because she was positive, she was treated with an oral medication only for almost two years. Sadly the oral medication doesn’t work forever and she eventually had to have chemo/radiation, and ultimately she died. But the oral drug gave her almost two years with a really good quality of life and few major side effects. Of course I forget the name but it’s well known and I’m sure if your uncle is a candidate the doctors will be aware.

Depends on the type of tumour. Some (rare) lung cancers are very slow growing and don't really spread, and can be removed in their entirety without any concern of remaining cells - they would check the tumour once removed to make sure it's all contained. A friend of mine had a lung tumour like this removed two years ago, had no chemo or radiation and remains all clear.

Depends on the type of cancer some just need removing and no other treatment.
a relative had a rare form of uterine cancer and she had an hysterectomy and no further treatment necessary.

They will have run tests before and after surgery, even if they were subtle tests from the patient POV (my medic friend was on to them when it happened to her "They are calling it a cyst but I think they're grading me for cancer...").

It probably means these tests were fairly good for your uncle and his prognosis is better. It's highly unlikely they just forgot to give him Chemo but I'm sure they will answer if he asks if he needs it. That would be a very normal question in his circumstances.

No. Not always. It depends on the staging.
Chemo and radiotherapy are used to shrink tumours and/or kill off cells if the cancer has spread to other organs or lymph nodes.
Mum didn't have either after her mastectomy. But her cancer was caught so early it was stage 0. She opted for a mastectomy when offered due to our family history. No need for chemo/radiotherapy.
It depends on how aggressive the cancer is. Know Your Tumour is really useful for cancer patients because it really gives them insight into their own individual type of cancer (cells). So certain types of cancer cells are more volatile than others. Others are very slow growing and don't require treatment pre/post surgery. Your uncle may have had a certain type of cancer that is simply not aggressive, which is wonderful news.

My lovely mil is going through this. She has a tumour in her left lung which was over 2/3rds of it, she was initially told that they wound operate to remove it as it hasn't spread, but when she went for her pre op the surgeon told her the odds of surviving the op were 40% and not only that, the days following are critical as your body can struggle to adjust without the lung etc . She is 73 and over weight and has copd as well though. She decided against having the op and is having chemo instead now. She was told by the surgeon if she had the op she would still possibly need chemotherapy afterwards but not definitely, so it's possible your uncle didn't need it.
It's such a worry isn't it because every case is different, and some people are quite private about their diagnosis /outlook.

Ps if the patient has a pet scan I believe it is very accurate at diagnosing the actual stage of the disease as well as marking if it's spread, I think they use this in deciding treatment as well.
That's what mil was told.

No, my mum has a very low grade of ovarian cancer, too low grade for chemo to be effective. No need for surgery, it is controlled by hormone tablets.

If you consider that there are more than 200 different cancers (at least 12 types of just breast cancer) then of course all treatment plans are going to be different. I was once told by an oncologist that the 'cure' for cancer is surgery - everything else is mopping up. So if cancer's spread or the surgery doesn't give good margins or it's in the lymph nodes or an area where surgery isn't possible (i.e. stomach) then systemic treatment (chemo) is recommended. Radiotherapy is part of the belt and braces approach as is hormone therapy after treatment to hopefully prevent recurrence.