Answers to your questions.

Abnormal body cells which can grow and invade the body. This is often caused by a mutation in your DNA that happens over time. This is similar to a typing error which your body could not correct. The incorrect information is repeated many times as cells divide. Cell division and multiplication is no longer controlled by the body and a tumour forms.

  • Radiation therapy/radiotherapy is the treatment of cancer using high energy X-rays.
  • Treatment effects and side effects are local. In other words, usually only the area receiving treatment will have side effects. For example: Nausea when you are treated over the stomach; diarrhoea when you are treated over the bowel.

Radiotherapy side effects are experienced in the area receiving treatment and therefore the only patients experiencing hair loss with this form of treatment are patients receiving brain or scalp radiotherapy.

  • All treatment is subject to approval or authorisation by the medical aid. Typically, a patient will see an oncologist for a first appointment. Treatment options will be discussed and agreed upon. The doctor will then submit a request to the medical aid. Medical aids typically approve plans within seven working days. This process is not controlled by the oncologist or their staff.
  • Once treatment is approved, the patient will be contacted by the radiotherapy unit (please see separate contact details). A planning scan is then scheduled. This scan is not diagnostic and the aim is not to look for additional areas of cancer. The aim is to transfer patient images to a planning computer for the oncologist to determine which areas to irradiate (and which organs to protect from radiotherapy).
  • These completed images with plans are then sent to a radiotherapist and a physicist for planning and approval. Once the doctor is satisfied that the plan is safe, the patient will be contacted by the radiotherapy unit for a second time to discuss a date on which treatment should commence.

This process can take up to two weeks and the patient will therefore not start treatment on the very first consultation with the oncologist.

  • Intensity-modulated radiation therapy.
  • IMRT uses multiple small beams of varying intensity to precisely treat a tumour. The radiation intensity of each beam is controlled and the beam shape changes throughout each treatment. The goal is to limit the dose to normal tissue while adequately treating the tumour/cancer.

Volumetric modulated arc therapy is a form of IMRT where the beam is constantly rotated around the patient. This limits side effects and enables adequate treatment of the tumour

Treatment of cancer using radiation from small, encapsulated radioactive sources (seeds). The seeds are placed close to/in the tumour to be treated.

Focused radiation beams targeting a well-defined tumour. This technique is generally best for small tumours. It allows doctors to give a high dose of radiation to the tumour in a short amount of time.

 

No. There are many types of chemotherapy and it is better to wait and find out which type you will need. You cannot base your decision on somebody else’s experience – especially not if the cancer site differs.

Chemotherapy is medication used to kill cancer cells. Cancer cells are human cells which underwent mutation and no longer function normally. Chemotherapy can be given intravenously (in a drip) or orally (by mouth).

A few chemotherapy drugs are available in tablet form, but the majority of drugs are still given in a drip.

Yes – your surgeon can place a venous port. This is done in theatre under anaesthesia.

Yes – you can receive the vaccine while on chemotherapy or radiotherapy treatment. The NCCN guidelines support this statement. They do go on to mention that your vaccine might not be as effective if you receive it while your white cell count is low (secondary to chemotherapy). The side effect profile is similar to that of the general public. If you are in doubt, please contact your oncologist.

It is very important to inform your oncologist of any chronic medication you are taking during your first consultation. All medication prescribed by another doctor should be continued until you are instructed to stop. As a rule, chronic medication is continued throughout cancer treatment.

White cells are involved in attacking foreign cells and bacteria in your body. If your white cell levels are low, you are vulnerable to infections. Chemotherapy can temporarily suppress white cell production in your bone marrow. This is one of the reasons why you are more vulnerable while on chemotherapy treatment. If your white cell levels do not recover sufficiently before your next cycle of chemotherapy, your treatment might have to be postponed. If the white cell levels are very low, your doctor might have to offer an injection (under the skin of your abdomen) to increase the levels. You should contact your doctor IMMEDIATELY if you develop a fever (higher than 38°C) while on chemotherapy. This could point to an infection due to low white cell levels. This situation can be fatal if left untreated, because your body cannot fight back. Admission to hospital is often required.

  • General measures to treat constipation apply. Drink sufficient fluids (preferably water).
  • If this is not sufficient, try over-the-counter medication, like Movicol or Senokot.
  • VERY IMPORTANT: Contact your doctor as soon as possible if you also suffer from vomiting while constipated, as this could point to possible bowel obstruction.
  • The most important thing is to remain hydrated. As long as you can replace all lost water orally, you can be managed at home.
  • If you are losing more fluid than you can take in (and especially if you have more than four episodes of diarrhoea for the day) you need to contact your doctor and possibly be admitted for intravenous fluids.
  • Over-the-counter drugs like loperamide (Imodium) can be used.
  • Replace fluids with Rehydrate or make your own. (Boil 1 litre of water and let it cool. Add 1 teaspoon of salt and 8 teaspoons of sugar). This fluid is more likely to be absorbed by your body than regular water.

If in doubt, always phone your doctor.

  • It is very important to take the nausea medication exactly as prescribed. For the first two days it is advised to take the medication regularly, even if you are not experiencing nausea at that moment.
  • Eat smaller meals more regularly and avoid carbonated (gas) cold drink and fatty foods.

If in doubt, please phone the doctor.

  • Keep the area clean and dry.
  • Wash with soaps containing as little additives as possible (e.g. Pure Glycerine soap).
  • Do not apply Vaseline, Tissue oil/vitamin E oil/any cream or ointment unless discussed with your oncologist.
  • We recommend Wesson Resurfacing balm.
  • Apply Maizena (corn flour) in the radiotherapy area to keep it dry.
  • Avoid any exfoliating agents in the radiotherapy field (this includes shaving of the affected area).
  • Do not dry the area vigorously after a shower, but rather pat it dry.
  • Avoid sun exposure.
  • Avoid exposure to pool water/chlorine.
  • Wear loose fitting clothes (preferably made from natural fibres such as cotton).
  • Avoid brassieres with underwire during breast radiotherapy.
  • It is important to inform your doctor should this happen.
  • You can rinse your mouth with a luke warm, mild salt and bicarbonate of soda solution (1/4 teaspoon baking soda and 1/8 teaspoon salt in a cup of water).
  • Rinsing your mouth with water containing aspirin can also offer pain relief.
  • Your doctor might also offer an alcohol-free mouth wash (like Corsodyl).

Once you have been seen by the oncologist our authorisation department will register you as an oncology patient.

  • It is important to maintain a balanced diet while on any sort of cancer treatment. Foods to avoid (which could exacerbate nausea) include fatty foods, carbonated (gas) cold drinks, and, in some cases, dairy.
  • Please discuss the loss of appetite or weight loss with your oncologist. He or she could suggest supplements or refer you to a dietician, should it be necessary.

Not all cancers are familial – in fact only 5-10% are inherited. While it is important to mention a family history to your doctor, a positive diagnosis does not mean your children/siblings will necessarily inherit the disease.

This is a team of specialists (oncologists, radiologists, surgeons, social workers, etc.) who gather to discuss patient cases and the optimal treatment options. Each case is unique and even though we follow international guidelines, there are some cases which do not fit specific criteria. The advantage of having multiple opinions is that the best plan can be sought and implemented.