The aim of cancer treatment for many people is to cure the cancer. In some cancers that are very slow growing, or that have spread beyond their original area of the body, the aim may be to control the cancer and delay its progress. The treatments that are most commonly used are briefly described below. These may be given alone or in combination.

Surgery is an important part of cancer treatment for many people. It may aim to remove all, or part, of a tumour. The effects of the surgery will depend on the part of the body being operated on and on the extent of the surgery. Many operations for cancer may be carried out as day surgery, which may mean that you only need to take a very short time away from work. Other operations are much larger and may mean spending a few weeks away from work. Some operations may mean that your ability to work is very much affected; for example, if you have to have a limb amputated.

Radiotherapy treats cancer by using high-energy x-rays that destroy the cancer cells whilst doing as little harm as possible to normal cells. Radiotherapy treatment that aims to cure the cancer will often mean that you need to go to the hospital every weekday for several weeks. Each treatment only takes a few minutes, but travelling to and from the hospital and waiting for the treatment may take up a large part of the day. Some people manage to continue to work during radiotherapy treatment, but may need to reduce their hours during this time. Other people stop working completely while they are having radiotherapy and for a few weeks afterwards.

Side effects

Radiotherapy may make you feel tired and can cause skin soreness in the area being treated. Other side effects of the radiotherapy will depend on the area of the body being treated. The side effects tend to begin a couple of days after the treatment starts and may slowly worsen as treatment goes on. The effects may continue for several weeks after the treatment has finished and then they usually gradually improve.

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy the cancer cells. The drugs are usually given as liquid through a drip into a vein, 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.

If chemotherapy is given by drip into a vein, it may take minutes, hours or days. The chemotherapy is usually followed by a few weeks of rest so that the body can recover from the effects of the chemotherapy. This is known as a cycle of treatment. Commonly, 4-6 cycles of treatment are given, which takes from 4-8 months. Some treatments for particular types of cancer last much longer than this, others may be shorter. Sometimes the chemotherapy is given continuously into the vein over a few months by a small portable pump. This is known as a continuous infusion.

Some chemotherapy treatments are given as tablets or capsules to take at home and they may cause very few side effects.

Chemotherapy affects people in different ways. Some people find that they cannot work at all. However, other people find that they can keep working or that they just need to take a few days off after their chemotherapy and can then work until their next chemotherapy treatment.

Side effects

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

Other common side effects of chemotherapy include: tiredness and weakness; feeling sick; a sore mouth; diarrhoea or constipation; numbness and tingling of the hands and feet; and hair loss. Medicines can be given to control some of 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 changing the level of particular hormones in the body, or preventing the hormones from being taken up by the cancer cells. Most hormonal therapies are given as tablets, but some are given as injections every few weeks or months.

Side effects

Hormonal therapies can cause side effects such as weight gain, hot flushes and sweats, tiredness and lowered sex drive. These treatments are usually given for months or years, but do not usually affect your ability to work.

Immunotherapy treatments stimulate the immune system to fight the cancer cells. Monoclonal antibodies attach to specific proteins on the cancer cells to destroy them.

Side effects

There are many different immunotherapy drugs and monoclonal antibody treatments. These drugs can cause side effects, including possible flu-like symptoms, chills, headaches, a temperature, low resistance to infection and tiredness (fatigue). Some treatments may also cause sickness and diarrhoea. Many people carry on working while they have immunotherapy or monoclonal antibody treatments, but tiredness can sometimes make this difficult.

Many people recover quickly and can live a normal life once their treatment has ended. However, some people will have ongoing problems caused by their treatment, for example:

• tiredness for months or sometimes years
• soreness of an arm after breast surgery
• needing to eat little and often after stomach surgery
• needing to go to the toilet often after bladder or bowel cancer treatment 
• problems with moving around if they have had a leg amputated.

If you have long-term side effects from your treatment, you may need a lot of understanding and support from your employer. Things that your employer can do to help you are discussed later.

Sometimes two different types of treatment may be equally effective in treating your cancer, but have different side effects and so will have different effects on your day-to-day life and your ability to work.

Doctors and other healthcare professionals can give you detailed advice about the individual treatments and how each will affect your ability to work. However, the final decision on which treatment to have, or whether to have treatment, should be yours.

It can be very helpful to find out as much as possible about the type of cancer you have and the treatments which are planned. You can then work closely with your doctors and be involved in choosing the treatment that best suits your situation.

You can discuss the benefits and possible risks of each treatment with the health professionals looking after you. It is important to remember that it can be very difficult to predict how treatment will affect a person. This is because the same treatment can affect people differently. An example is that for two people given the same dose of the same chemotherapy drug, one may have very few side effects and be able to carry on working. The other person may have severe side effects and be unable to work for a while.

Questions you may want to ask your doctor

• What treatments are available for my type of cancer?
• How effective is the treatment likely to be?
• How will my treatment affect my physical ability to do my job? (eg, Can I drive? Can I climb ladders? Can I work shifts? Can I travel by plane?)
• Are there any treatment options that will make it easier for me to work?
• What are the benefits and disadvantages of the treatment?
• How long will each treatment take and what does it involve?
• Will I have to be admitted to hospital?
• What are the possible side effects of treatment?
• What can be done about the side effects of the treatment?
• How much is the treatment likely to affect my day-to-day life?
• Will I still be able to work while I am having the treatment?
• What will happen if I don’t want to have any treatment?

Once you have the answers to these questions, you may need time to think through your choices, and discuss them with your family or friends.

If you find it difficult to decide between the treatment options, it may help to talk to people who have already had those treatments. Your doctor may be able to put you in touch with other patients.

Many cancer organisations and support groups can also help you to find someone who has had a particular treatment.

It is often possible to find information about cancer and its treatment on the internet; however there is also a lot of misleading or inaccurate information. If you look for information on the internet it is important to use only high-quality and reputable sites.

Some people prefer to leave treatment decisions completely to their doctors, as they find this easier and less stressful. However, even if you decide to do this, it is helpful to take the time to understand what your treatment will involve and how it will affect your ability to work.