The aims of cancer treatment are either to cure the cancer, or to control the disease and delay its progress. Often it is unclear at the time of diagnosis whether a cure will be possible. If your doctors think that it may be possible to cure the cancer, they will recommend the strongest or most effective treatments.

In some people it will be obvious from the beginning that a cure is not possible. In that situation it is more important to choose treatments that will control symptoms, while causing fewer side effects.

Surgery may be a very important part of cancer treatment for many older people with cancer. Surgery may aim to remove all, or part, of a tumour.

With careful assessment before an operation, expert anaesthetic care during the operation, and good nursing care after surgery, older people can benefit from even very extensive surgery. However, some operations carry such a high risk at any age that this will need to be balanced carefully against the possible benefits of the surgery.

Sometimes other treatment such as hormonal therapy, chemotherapy or radiotherapy may give similar long-term benefits, while avoiding the risks of an operation.

Radiotherapy treats cancer by using high-energy x-rays which destroy the cancer cells while doing as little harm as possible to normal cells.

Radiotherapy is the best type of treatment for some cancers and is sometimes used with surgery or other treatments. Radiotherapy may also be used if you are too frail to have an operation or chemotherapy. Studies have shown that most people who are initially reasonably fit are able to cope well with radiotherapy. The side effects of the treatment will depend on the area of the body that is being treated.

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy the cancer cells. The drugs are usually given as a liquid through a drip so that they can circulate in the bloodstream and reach the cancer cells wherever they are in the body. Some types of chemotherapy are taken as tablets or capsules. Some types of skin cancer may be treated with chemotherapy creams.

It is important that your doctors know about any other health problems before they choose your treatment. Some chemotherapy drugs can temporarily affect the normal working of the heart, liver, kidneys or lungs, so it is important to let your doctors know about any other health condition that you have. Some chemotherapy drugs should not be given at the same time as certain medicines for heart, kidney and lung disease.

Chemotherapy can cause side effects which may be troublesome. It can temporarily stop the bone marrow from making new blood cells. This can lead to bleeding problems, infections or anaemia. If the bone marrow is not working properly you may need to take antibiotics to treat an infection, or have a blood transfusion if you are anaemic. Your doctors will take regular blood tests between courses of treatment to check its effects.

Other possible side effects of chemotherapy include feeling sick (nausea), a sore mouth, diarrhoea or constipation, and hair loss. Medicines can be given to control these effects. The side effects will gradually disappear once the treatment has finished.

Hormonal therapies are drugs that can stop or slow the growth of cancer cells by either altering the level of particular hormones in the body, or preventing the hormones from being taken up by the cancer cells.

Hormonal therapies are often given for several years. They can cause side effects such as weight gain, hot flushes and sweats, tiredness and a lowered sex drive.

Immunotherapies are treatments that stimulate the body’s immune system to attack cancer cells. The side effects may include flu-like symptoms, tiredness, feeling sick and a poor appetite.

Monoclonal antibodies are drugs that attach themselves to particular proteins on the surface of cancer cells. They then disrupt the process by which the cells divide and grow. Monoclonal antibodies tend to cause few side effects but these can include a poor appetite, flu-like symptoms and tiredness.

Some cancers grow very slowly and may never cause any problems within a person’s lifetime. In this situation the doctors may feel that it is better not to give any treatment, as this may cause side effects which would reduce the person’s quality of life. However, the doctors will still monitor people closely, usually by seeing them every few months to assess their condition. They will then do blood tests and scans, if necessary.

If the cancer begins to develop, the doctors will detect this early and can offer appropriate treatment at that time. Some people find it very difficult not to have treatment when they know that a cancer is there. It is important to discuss the situation fully with your doctor so that you understand why no treatment is being given.