Understanding Your Cancer Treatment Options
Surgery, Chemotherapy, Radiation, Immunotherapy, and Targeted Therapy
Understanding how different cancer treatments work can help you feel more informed, prepared, and confident as you navigate important decisions with your oncology team.
Explore Treatment OptionsMaking Sense of Your Treatment Options
When you are first diagnosed with cancer, one of the most overwhelming parts of the experience can be understanding your treatment options.
Your oncologist may begin discussing surgery, chemotherapy, radiation therapy, immunotherapy, or targeted treatments. You might hear unfamiliar terms such as neoadjuvant therapy, adjuvant therapy, or biomarker testing.
It can feel like you are suddenly expected to understand an entirely new medical language while processing some of the most difficult news of your life.
You do not have to understand everything about cancer treatment in one appointment. Learning the basics of your options can help you participate more confidently in conversations with your oncology team.
First, Understand the Goal of Your Treatment
One of the most important questions you can ask is: "What is the goal of my treatment?"
Curative Treatment
The goal is to eliminate the cancer and achieve a cure. Depending on the diagnosis, this may involve one or several treatment approaches.
Controlling Cancer
The goal is to stop or slow cancer growth, sometimes for an extended period, while maintaining quality of life.
Relieving Symptoms
Palliative treatments may help relieve pain or other symptoms. They can be provided alongside treatments intended to control or cure cancer.
Your treatment recommendations depend on your cancer type, stage, location, overall health, and sometimes the molecular characteristics of the cancer itself.
Understanding the Different Treatment Modalities
Each treatment works differently. Your oncology team may recommend one approach or a combination.
Surgery
Removing cancerous tissue
02Chemotherapy
Medications that attack cancer cells
03Radiation
Targeted treatment using radiation
04Immunotherapy
Helping your immune system fight cancer
05Targeted Therapy
Targeting specific cancer characteristics
06Hormone Therapy
Blocking hormones that fuel some cancers
Surgery: Removing the Cancer
Surgery is one of the oldest and most commonly used treatments for cancer. The basic concept is straightforward: a surgeon removes cancerous tissue from the body.
For many solid tumors, particularly cancers that have not spread to distant organs, surgery may offer an opportunity for cure.
Why Might Surgery Be Recommended?
- Remove a cancerous tumor completely.
- Remove or examine nearby lymph nodes.
- Reduce the size of a tumor.
- Relieve symptoms such as pain or obstruction.
- Obtain tissue for diagnosis or additional testing.
Understanding Adjuvant and Neoadjuvant Therapy
Adjuvant therapy is treatment given after surgery to help reduce the risk of cancer returning.
Neoadjuvant therapy is treatment given before surgery, often to shrink a tumor or improve the chances of successful surgery.
Questions to Ask Your Surgeon
- What exactly will be removed?
- Is the goal to remove all the cancer?
- How long will recovery take?
- What complications or long-term effects are possible?
- Will I need treatment before or after surgery?
Chemotherapy: Treating Cancer Throughout the Body
Chemotherapy uses medications to destroy cancer cells or prevent them from growing and dividing.
Many traditional chemotherapy medications work by interfering with rapidly dividing cells. Because many chemotherapy drugs travel through the bloodstream, they may treat cancer cells beyond the original tumor.
How Is Chemotherapy Given?
- Intravenously through a vein.
- Through an implanted chemotherapy port.
- As oral medications taken at home.
- Through injections or other specialized routes.
Chemotherapy is often administered in cycles, allowing time for treatment followed by recovery. The schedule depends on the medications and the cancer being treated.
What About Side Effects?
Chemotherapy can affect some healthy cells in addition to cancer cells. Depending on the medications, possible side effects include fatigue, nausea, hair loss, low blood counts, mouth sores, or numbness and tingling.
Not every chemotherapy medication causes the same side effects. Your oncology team has many options to help prevent or manage treatment-related symptoms.
Questions to Ask About Chemotherapy
- Why is this chemotherapy recommended?
- Which drugs will I receive?
- How frequently will treatments occur?
- Which side effects are most likely?
- Which symptoms require an immediate call?
- Would an implanted port be appropriate?
Radiation Therapy: Precisely Targeting Cancer Cells
Radiation therapy uses high-energy radiation to damage cancer cell DNA, making it difficult for cancer cells to continue growing and dividing.
External-beam radiation is typically a local treatment, directed toward a specific area of the body.
Types of Radiation Therapy
- External-beam radiation: A machine directs radiation toward the treatment area.
- Brachytherapy: Radioactive material is placed inside or near a tumor.
- Stereotactic radiation: Highly focused radiation delivered with precision.
- Systemic radionuclide therapy: Radioactive medications travel through the body to reach certain cancer targets.
Does Radiation Hurt?
External-beam radiation itself is generally painless while being delivered. However, treatment can cause side effects depending on the area of the body receiving radiation.
External-beam radiation does not make you radioactive. Some treatments involving radioactive medications or implants may require temporary safety precautions.
Questions to Ask Your Radiation Oncologist
- Why is radiation recommended?
- How many treatment sessions will I need?
- What part of my body will be treated?
- What short-term and long-term effects are possible?
- How will nearby healthy tissues be protected?
Immunotherapy: Helping Your Immune System Fight Cancer
Immunotherapy helps the body's immune system recognize, respond to, or attack cancer cells more effectively.
Cancer cells sometimes develop ways to avoid immune detection. Certain immunotherapies interfere with those mechanisms, allowing immune cells to respond more effectively.
One commonly used type of immunotherapy is called an immune checkpoint inhibitor.
Is Immunotherapy Easier Than Chemotherapy?
Not necessarily. Immunotherapy works differently from traditional chemotherapy and has a different set of possible side effects.
Because these medications affect immune responses, they can sometimes cause inflammation in healthy organs, including the lungs, intestines, liver, skin, or thyroid.
Report new or unusual symptoms to your oncology team. Some immune-related side effects can become serious if they are not recognized and treated promptly.
Questions to Ask About Immunotherapy
- Is immunotherapy appropriate for my cancer?
- Are any tests needed before treatment?
- What immune-related side effects should I watch for?
- How will you determine whether it is working?
Targeted Therapy: Treating Cancer Based on Its Characteristics
Even patients with the same type of cancer may have tumors with different molecular characteristics.
Targeted therapies are medications designed to interfere with specific proteins, molecules, or pathways that help cancer cells grow and survive.
What Is Biomarker Testing?
Biomarker testing looks for characteristics in cancer cells that may help guide treatment decisions.
Examples include:
- HER2-related treatments for certain breast cancers.
- EGFR- or ALK-directed treatments for certain lung cancers.
- BRAF-targeted treatments for some melanomas.
Not every cancer has an actionable biomarker or an available targeted treatment.
Do Targeted Therapies Cause Side Effects?
Yes. Side effects vary by medication and may include rashes, diarrhea, fatigue, high blood pressure, or changes in liver function.
Questions to Ask About Targeted Therapy
- Has my tumor been tested for relevant biomarkers?
- Were any molecular changes identified?
- Is there a targeted treatment for my cancer?
- How is the medication given?
- What side effects should I monitor?
Hormone Therapy: Blocking Hormones That Help Cancer Grow
Certain cancers depend on hormones to grow. Hormone therapy, also called endocrine therapy, works by reducing hormone levels or blocking hormone effects on cancer cells.
It is commonly used in some breast and prostate cancers.
Hormone treatment may involve pills, injections, or other approaches that alter hormone production.
Potential side effects depend on the treatment and may include hot flashes, fatigue, sexual changes, or bone-density loss.
Hormone therapy used to treat cancer is not the same as hormone replacement therapy.
Other Specialized Cancer Treatments
Cancer care continues to evolve. Depending on your diagnosis, additional treatments may be available.
Stem Cell Transplantation
Used in certain blood cancers to restore blood-forming stem cells after intensive treatment.
CAR T-Cell Therapy
A specialized immunotherapy in which a patient's T cells are modified to recognize and attack certain cancer cells.
Antibody-Drug Conjugates
Medications combining a targeting antibody with an anticancer drug.
Clinical Trials
Research studies evaluating new treatments or new ways of using existing therapies.
Why Might I Need More Than One Treatment?
Different cancer treatments work in different ways. That is why your oncology team may recommend combining several treatment approaches.
For example, some patients receive chemotherapy before surgery to shrink a tumor, followed by surgery and possibly radiation afterward.
Other patients undergo surgery first and then receive additional treatment to reduce the chance of recurrence.
"Can you explain the purpose of each treatment in my plan and how the treatments work together?"
Understanding Multidisciplinary Cancer Care
Cancer treatment often involves several specialists working together to create an individualized plan.
Medical Oncologist
Manages medications such as chemotherapy, immunotherapy, targeted therapy, and hormone therapy.
Surgical Oncologist
Evaluates whether surgery is appropriate and performs cancer-related procedures.
Radiation Oncologist
Develops and oversees radiation treatment plans.
Supportive Care Team
May include oncology nurses, navigators, social workers, dietitians, financial navigators, and palliative care specialists.
Ask whether your case has been reviewed by a multidisciplinary tumor board, particularly if you are facing complex treatment decisions.
Don't Forget Supportive and Palliative Care
Cancer treatment is not just about attacking cancer cells. It is also about maintaining your physical, emotional, and practical well-being.
Supportive care may help with fatigue, nausea, nutrition, pain, sleep problems, anxiety, and other treatment-related challenges.
Palliative care focuses on symptom management and quality of life and can be provided at any stage of cancer treatment.
Palliative care can be provided alongside cancer treatments intended to cure or control the disease.
Your Cancer Treatment Question Checklist
Bring these questions to your next oncology visit. You don't have to remember every answer.
- What type and stage of cancer do I have?
- What is the goal of my treatment?
- Which treatments are recommended, and why?
- Are there other reasonable treatment options?
- Has my cancer been tested for relevant biomarkers?
- Will I need more than one type of treatment?
- What is the expected treatment schedule?
- How will we know whether treatment is working?
- What side effects should I anticipate?
- Which symptoms require immediate attention?
- Are there long-term effects I should understand?
- Should I consider a second opinion or clinical trial?
- What supportive care services are available?
Take Your Treatment Checklist With You
Download and print this checklist to help organize your questions, take notes, and prepare for conversations with your cancer care team.
Download Your Checklist PDF A printable resource for your next appointment.Understanding Your Options Can Help You Feel More Prepared
A cancer diagnosis can leave you feeling as though important decisions must be made before you have had time to understand what is happening.
But you deserve explanations that make sense to you.
Whether your treatment involves surgery, chemotherapy, radiation, immunotherapy, targeted therapy, or a combination of approaches, your oncology team should help you understand why each treatment is recommended.
Ask questions. Write things down. Bring someone you trust to appointments. And remember that you are an important member of your own cancer care team.
Knowledge does not remove every uncertainty of cancer, but it can help you approach treatment with greater confidence and a clearer understanding of your choices.
You Don't Have to Navigate Cancer Alone
Cancer coaching can help you organize your concerns, prepare for appointments, understand the questions to ask, and feel more confident communicating with your healthcare team.
Let Sandra Alverson, MSN, RN, OCN, help you feel informed, prepared, and supported throughout your cancer journey.
Request a ConsultationMore Resources for Your Cancer Journey
This article is intended for general education and does not replace individualized medical advice. Always discuss treatment decisions with your oncology team.
