How Does Treatment Work?
What Are Treatment Side Effects?
Things To Look For
Want To Visit?
Your Own Ups and Downs During Treatment
Where Do Kids Get Treated for Cancer?
Who Can Answer My Other Questions?
You may want to know what to expect during your brother's or sister's cancer treatment. This section briefly explains different treatments. It talks about how they work and their side effects. You will probably have more questions after reading this section. It may help to talk with your parents. Or ask if you can talk with your sibling's nurse or social worker.
"Rachel had all this beautiful hair. But during treatment, she'd wake up and find hair all over her pillow. It would also fall out when she combed or washed it. I could hear her crying in the bathroom. One day Mom helped her shave her head. Then we bought and decorated some bandanas together. They look good on her. My sister is my hero."
- Lauren, age 12
Cancer treatment aims to get rid of cancer cells. The type of treatment your brother or sister will be given depends on:
- The type of cancer
- Whether the cancer has spread
- Your sibling's age and general health
- Your sibling's medical history
- Whether the cancer is newly diagnosed or has recurred.
Remember that there are more than 100 different types of cancer, and each type is treated differently.
Treatment follows a protocol, which is a treatment plan. But even if two people have the same type of cancer and the same treatment plan, it may not work the same way for both of them. This is because people's bodies can react differently to treatment. Most children with cancer are treated at large pediatric cancer centers in clinical trials. A clinical trial is a study that helps show how, for example, a promising anticancer drug, a new test, or a possible way to prevent cancer affects the people who receive it.
Side effects happen because the cancer treatment targets fastgrowing cells. Cancer cells are fast growing, but so are normal cells like the ones in the digestive tract and hair, for example. The treatment can't tell the difference between fast-growing normal cells and fast-growing cancer cells. That's why people sometimes get sick to their stomach and lose their hair when they have chemotherapy (one type of cancer treatment).
Some side effects, like feeling sick to the stomach, go away shortly after treatment, while others, like feeling tired, may last a while after treatment has ended.
Write down what treatment your brother or sister will get:
Use the chart on the next two pages to find out more about different types of cancer treatment.
The chart describes six types of cancer treatment, how they're done, and some of the side effects. Your brother or sister may get one or more of these treatments. Depending on the exact treatment, they may visit the doctor during the day, or they may stay overnight in the hospital.
|Treatment||What is it?||How is it done?||What may happen as a result? (side effects)|
Also called an operation
|The removal of all or part of a solid tumor||A surgeon operates to remove the cancer. Drugs are used so that the patient is asleep during surgery.|
Also called radiotherapy
|The use of high-energy rays or high-energy particles to kill cancer cells and shrink tumors||Radiation may come from a machine outside the body or from radioactive material placed in the body near the cancer cells.|
Also called chemo
|The use of medicine to destroy cancer cells||The medicine can be given as pills, through an injection (shot), or through an intravenous (IV) line. It is often given in cycles that alternate between treatment and rest periods.|
|Stem cell transplantation|
Can be a bone marrow transplantation (BMT) or a peripheral blood stem cell transplantation (PBSCT)
|The use of stem cells found in either the bone marrow or the blood. This repairs stem cells that were destroyed by high doses of chemo and/or radiation therapy.||Stem cell transplantation uses stem cells from the patient or from donors. In many cases, the donors are family members. The patient gets these stem cells through an IV line.|
|Hormone therapy||A treatment that adds, blocks, or removes hormones from the body. Hormone therapy is especially useful to slow or stop the growth of some types of cancers.||Hormone therapy can be given as a pill, through an injection, or through a patch worn on the skin. Sometimes surgery is needed to remove the glands that make specific hormones.|
Also called immunotherapy
|Biological therapy uses the body's own defense system (the immune system) to fight cancer cells.||Patients may be given medicine in pills, through an injection, or through an IV line.|
Your brother or sister will get tests to monitor the cancer and how the treatment is working. See Chart A in the back of this booklet for a list of some common monitoring tests.
Some treatments may make your brother or sister more likely to get an infection. This happens because cancer treatment can affect the white blood cells, which are the cells that fight infection. An infection can make your brother or sister sicker. So your sibling may need to stay away from crowded places or people who have an illness that he or she could catch (such as a cold, the flu, or chicken pox).
Because of this, you may need to:
- Wash your hands with soap and water often to keep from spreading germs
- Tell a parent when you've been around someone who's sick or has a cold
- Stay away from your brother or sister if you get sick.
It's hard to wait to see how well the treatment will work. Your brother's or sister's doctor may try one treatment, then another. One day your brother or sister may feel a lot better, and the next day or week they may feel sick again. Treatment can go on for months or sometimes years. This emotional roller coaster is hard on everyone.
During this time, remember that the treatment is working to stop the cancer and make your brother or sister better. For more information about the people who will be treating your brother or sister, see Chart B in the back of this booklet.
"I looked forward to the times I got to visit my big sister when she was in the hospital. Sometimes it was really sad to see Tara in bed because she looked so weak. But I am glad I went. Now my sister is home, so I get to see her again."
- Allie, age 14
Close to home
If your brother or sister is in a hospital near you, you may be able to visit. Learn ahead of time how your sibling is doing and what to expect. You can read together, draw, play games, or sit and talk. Some teens also want to help care for their brother or sister. Ask the nurse what you can do if you are interested.
Far from home
When your brother or sister is getting treatment far from home, you may not be able to visit them as often. It will help you both to stay in touch. Talk on the phone. You can also send cards, letters, or pictures back and forth.
During your brother's or sister's treatment, you may go through a whole new range of feelings.
Does this sound like how you feel sometimes?
- I feel frustrated.
- I feel left out.
- I feel invisible - my sibling is getting all the attention.
- I feel like treatment has gone on so long.
- I am so sad that my sibling is so sick.
- I wonder why this is happening to our family.
- Some days I want to know all the details about treatment. Other days I just want to forget it ever happened.
All of these feelings are natural. Try to share your thoughts with your friends, parents, or another trusted adult. This time can be tough on every member of your family. Talking things through can help when you are feeling left out, sad, or confused.
|Where to go for more information|
|To learn more about cancer treatments, visit the NCI Web site (http://www.cancer.gov). Look for the booklets Chemotherapy and You, and Radiation and You, among others. You can also call the NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237) to talk with an information specialist. All calls are free and confidential.|
"One day I went to the clinic with my brother for his treatment. I saw the machine that he gets radiation from. I got to meet his doctor and nurses and see lots of other kids with cancer. I still wish Jake's treatment was over, but I feel better knowing more about what is going on."
- Matthew, age 15
Most kids get treated at cancer treatment centers that are just for children and teens. There may be a center near you. Or your brother or sister may have to get treatment in another city or state. Your parent and your sibling, or your whole family, may go live in a new city during treatment.
"At first I didn't ask any questions, although I had a lot of them. I thought people would think I was really dumb, but now I know it really helps to ask."
- Brad, age 15
Ask your parents or another trusted adult any questions that you have. Ask if you can go along and maybe talk with a doctor or nurse when your parents take your brother or sister to the doctor.
To make things easier:
- Make a list of questions and bring the list with you.
- Ask people to explain things using simple words.
- Ask for the information to be repeated.
- Ask the doctor or nurse to show you things on a model or draw a picture.
|Questions you might want to ask|
|Questions about the treatment|
|Write down your own questions:|
It's okay to ask these questions more than once.
"I was surprised to find out about stem cell donation because I didn't think I would have any role in my sister's treatment. So when I was asked to be a donor, I felt like it was a chance to help her in an important way. At first I had a lot of questions. A nurse was the person that helped me the most."
- Ethan, age 17