Text OnlyPrint View

The Cancer Journey

The cancer journey is an individual's experience of cancer. It may include screening, detection, diagnosis, treatment, recovery, 'living with cancer' or palliative care. The cancer journey does not look the same for everybody, even if they have the same type of cancer. Depending on the stage of cancer and other underlying conditions or issues, the symptoms and treatment may be quite different. Different people may also react differently to various cancer treatments.

Many people want to take an active part in making decisions about their medical care and it is important to learn all you can about the disease and the treatment choices available.

On this page you will find information about:

Cancer Journey

Primary Care

A visit to the Doctor or clinic for a routine check up may reveal signs that require further investigation. Sometimes people have particular symptoms that are highly indicative of cancer, but some early stage cancers have little or no obvious symptoms. Your Doctor may request further tests to make a Diagnosis or may refer you to an appropriate specialist. This could be an Oncologist (solid tumour specialist), Haematologist (blood cancer specialist), Surgeon or specialist Physician.

Diagnostic Tests

Your Doctor will explain in detail the type of tests to be performed and their relevance to your situation. Depending on the symptoms that are present, you may need to undergo one or more of the following tests to determine a diagnosis:

  • Biopsy - The removal of a small amount of tissue or fluid for examination to detect cancer cells
  • Blood test - The extraction of blood for testing of abnormal cells
  • Computerised Tomography (CAT) Scan - A series of detailed pictures taken using x-rays from cross-sections of the body at different angles. Also called a CT scan or a Computerised Axial Tomography (CAT) scan
  • Endoscopy - A procedure that uses an endoscope to examine the inside of the body. An endoscope is a thin, tube-like instrument with a light and lens for viewing. It may also have a tool to remove tissue (biopsy) to be checked under a microscope for signs of disease
  • Magnetic Resonance Imaging(MRI) - An MRI is a non-invasive imaging method that uses both magnetism and radio waves. It provides cross-section images of a particular part of the body to determine the size and shape of a tumour
  • Mammogram - Radiological (x-ray) used to identify cysts, calcifications and tumours within the breast
  • Positron Emission Tomography (PET) Scan - A nuclear medicine imaging technique that produces a 3D image or map of internal organs. PET scans are not available in the NT
  • X-Rays - A type of high-energy radiation in which a small quantity is used to take pictures of the inside of the body to diagnose cancer. In high doses, x-rays are used to treat cancer (radiotherapy)
  • Ultrasound - The ultrasound device uses sound waves that people cannot hear. The device aims sound waves at organs inside the pelvis and the waves bounce off the organs. A computer creates a picture from the echoes

Diagnosis

A Diagnosis of cancer will take into account the symptoms (if any), medical history and test results. It may be hard to fully understand and comprehend the diagnosis, as many people experience feelings of shock, denial and disbelief. Coping with these feelings is one of the most difficult parts of dealing with cancer. Feelings of anger and sadness are usually felt and people report feeling concerned and uncertain about the future. For more information see our Living with Cancer page.

There may be questions you want to ask of your Doctor but forget in the rush of the moment. Writing down questions you would like to ask and even recording the consultation might help you to remember and prompt you to ask further questions. It may also be good to have a family member or friend accompany you for support and to prompt or ask questions. Some cancer organisations produce diaries to help people remember questions, answers and test results. One example is "My Journey Personal Record" developed by The Breast Cancer Network Australia.

Some examples of questions you may want to ask are:

  • What are my Treatment choices? Which do you recommend for me and why?
  • What are the benefits of each treatment? What are the risks of each treatment? What are the side effects of each treatment?
  • Where can I get more information to help me make decisions about treatment?
  • Will I be able to work? How long will I be off work?
  • How will it effect my life and relationships?
  • Has the cancer spread? Where has it spread?
  • Do I need other tests?

The Cancer Institute NSW has created fact sheets "Asking Questions is Important" - Question Prompt Lists - Information for Oncology Health Professionals, which will assist you in asking the correct questions, at the correct point in your journey.

cancer journey img 2.jpg

Referral to Specialists

Once a Diagnosis has been confirmed, your Doctor will refer you to the appropriate specialist Surgeon, Oncologist and/or Haematologist. The specialist will determine the Treatment options available to you and develop a Treatment plan with you, taking your preferences into account. Treatment planning involves all aspects of cancer care such as surgery, chemotherapy or radiation, and also whether you may benefit from other services such as psychosocial support and allied health services (physiotherapy, occupational therapy, dietetics, speech pathology, audiology, social work and psychology). For more information on those who can help in numerous areas you can visit our Multidisciplinary Teams page under canNET NT.

Certain types of cancer such as central nervous system cancers, blood cancers or rare types of cancers as well as cancers in children, require specialist treatment, which cannot be accessed in the Northern Territory. People who are diagnosed with any of these types of cancers need to travel interstate for treatment. For more information on interstate travel see our information on Patient Assistance Travel Scheme (PATS).

Treatment

In order to recommend and plan the best treatment, your Doctors need to know the specific type and also the extent of the cancer. This is referred to as 'staging' and attempts to determine how advanced the cancer is, whether it has spread and if so, to which parts of the body.

Your Doctor will explain all Treatment options and the expected outcomes of each one. You will have an opportunity to ask any questions that may assist you in making Treatment decisions. By working together with your doctor and other relevant health care professionals you will be able to draw up a Treatment plan that will meet your medical needs and personal values.

There are several different types of Treatment that can be used on their own or in conjunction with other treatments. The recommendations about the combination of treatments will depend on your type and stage of cancer. The main types of Treatment are surgery, radiotherapy and chemotherapy. Details on some other options available can be found in our Treatment Options page.

Radiotherapy treatment is now available at the Allan Walker Cancer Care Centre located on Royal Darwin Hospital precinct grounds off Rocklands Drive in the suburb of Tiwi. Some cancers requiring specialist Treatment will still be treated interstate. For more information on interstate travel see our information onPatient Assistance Travel Scheme (PATS).

Follow-up and Monitoring

Follow-up care and monitoring after Treatment are important to ensure that a recurrence of cancer is detected early. Depending on the type of cancer and your Treatment plan, it is important to discuss the frequency of visits for after care with your specialists and GP and to determine who will be the best person to perform such follow-up. The time frame for follow-up can range from three to twelve months and can depend on the type and aggressiveness of the cancer. As time passes your follow-up visits will become less frequent unless there are signs of a recurrence.

Follow Up and MonitoringIn some cases once Treatment has been completed, some cancer cells may remain undetected in the body. Therefore check ups with your Doctor and healthcare professionals should be done on a regular basis.


Cancer Outcomes

The most desirable outcome of cancer Treatment is remission. However, in some cases complete remission does not occur, and plans for further Treatment or palliative care must be made. These options are described below:

Remission

Treatment of cancer may control the disease, leading to partial or complete remission. If you are in partial remission, some but not all of your signs and symptoms will have disappeared or have been reduced. It is important to realise that the cancer may still be present in your body even if you are considered to be in remission. You are generally considered to be in complete remission if there are no signs and symptoms of cancer for a period of five years or longer following treatment.

Recurrence of Cancer

In some cases cancer can return after a period of improvement or remission. This can happen at any time, from a few weeks to several years after completion of treatment. The cancer may recur at the primary cancer site or in another part of the body. In this instance, your Doctor will do tests and once again discuss all Treatment options with you. In some instances, recurrent episodes of cancer can be effectively controlled with Treatment for long periods of time.

Advanced Cancer

Advanced cancer is a term commonly used to describe primary cancer or metastatic/secondary cancer that is unlikely to be cured. Often this is a recurrence of cancer that has already been treated. Advanced cancer usually cannot be cured, however, it can be treated to slow the growth and spread of the cancer for months or years, and reduce symptoms.

People with advanced stages of cancer have a life limiting illness. Even if they are initially feeling well, death is a likely part of the future as the cancer grows and may spread to vital organs such as the lungs or brain. Treatment will be focused on ways to enhance quality of life while managing symptoms such as pain. Palliative Care is an approach that aims to improve the quality of life for the person with cancer, their family and carers. It addresses the prevention and Treatment of pain and other physical, psychosocial and spiritual issues related to the process of dying (WHO, 2005). Please visit our Territory Palliative Care page for more information.