Jewish Health

Other treatments

The decision about whether or not to have surgery can be very significant, depending on the particular health condition (see also BRCA mutations and preventive surgery). Women at significant risk of developing cancer can now take medications instead of having surgery. Tamoxifen and raloxifene work by blocking the effects of oestrogen on tissues, and are an option for reducing the risk of breast cancer for some women. Using these medications would be a decision made with specialist genetic doctors, and would involve balancing up the possible risks and benefits.
Several people with Crohn’s disease who had a hemicolectomy to remove some of the inflamed section of their bowel said they felt very well for several years afterwards. Carol had this operation once in her mid-twenties and has had no recurrence of the disease since. For most people though, more than one bowel resection was needed. Harvey had three over the years and had felt very well for several years after each operation. Sometimes people needed to have a resection as an emergency operation. After trying other treatments which hadn’t worked, Sara was worried about her 12 year old son having a small part of his intestine removed because she felt it was the beginning of a process where they would keep “snipping bits off”, but since Crohn’s disease would be stunting her son’s growth during his teenage years they decided to have the operation.
Part of the process of investigating changes in the bowel usually involves having a colonoscopy. People we spoke to felt that this was an embarrassing and unpleasant procedure. Although Sylvia was dreading having a colonoscopy, she was pleased she had it done because she is now on medication which is helping her symptoms. Several people thought that the preparation for the colonoscopy (which often involves taking medicines to clear out the bowel and empty it fully before the colonoscopy) was worse than the actual procedure, which they were sedated for.
People with more serious Crohn’s disease had a colostomy or an ileostomy, both of which involved having a stoma bag. Harvey took a year to recover from his colostomy operation but he has gradually become accustomed to living with a stoma. Gareth was resistant to having a stoma bag for an ileostomy but he had it successfully for six months to a year.
 
Deciding on which treatment to have for particular health conditions can be difficult and is aided by being given appropriate information at the appropriate time. Several people were involved in the decisions about their treatment and some talked about seeking a second opinion. M, for example took the CDs of his MRI scan to get a second opinion and consulted doctors in Israel. He found out his deep brain stimulation hadn’t worked because it was 6-7 millimetres off target.
Medication
 
Many people with Crohn’s disease were prescribed steroids to treat their illness. They are usually only used to treat active disease because of the long term side effects. Some had taken many courses of steroids over their life and they had been very effective in managing their symptoms. Linda said that if she has a flare up, by taking steroids within 24-48 hours the symptoms are under control. Harvey had lots of surgery but was still having problems. Since taking Budesonide he has been ‘fairly free of problems’.
 
Sometimes steroids aren’t tolerated or effective for an individual. Sara’s 12 year old son went “completely manic” and hyperactive (see Side effects), and although his Crohn’s disease did improve, he had to stop taking them. Several people were unhappy about taking steroids because of their known side effects (see Side effects).
 
Other forms of medication used by people to manage Crohn’s disease included, immunosuppressants, Sulfasalazine, Questran Light and antiTNF antibodies such as infliximab. Many people with Crohn’s disease also had regular Vitamin B12 injections.
Synthesised enzymes
 
Gaucher disease can be treated using synthesised enzymes which are placed in the body via a drip. After a lot of pursuing by his wife, Gary was able to have this drug and he was taught to self-cannulate so he could have it at home.
Cancer Treatments
 
Surgery is often the first treatment for breast or ovarian cancer, if the tumour is diagnosed early enough to allow it. Some women were able to have lumpectomies to remove the cancer in their breast, others had a mastectomy. Surgery can also be done after a course of chemotherapy to shrink the tumour, or as a preventative treatment for breast or ovarian cancer (see BRCA mutation and preventive surgery). Sometimes surgery is followed by a course of chemotherapy and/or radiotherapy, or sometimes an oncologist will advise only chemotherapy or radiotherapy (for more information see our sections on ‘Breast Cancer in women’ and ‘Ovarian Cancer’). Harriet had low dose chemotherapy on her right ovary and regular screening but it didn’t work, the tumour grew and she needed to have a radical hysterectomy.
Stem cell replacement therapy is used to treat multiple myeloma. David’s first stem cell treatment was successful at controlling his myeloma for two and a half years and he is planning to have another stem cell replacement therapy operation in the near future.
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There are various different chemotherapy regimes to treat cancer, all of which have different side effects (see Side effects).

Some women develop lymphoedema after treatment for breast or ovarian cancer. Harriet developed it in her leg and Goldie developed it in her arm (see Side effects). Treatment involves wearing compression sleeves and exercises. 

Last reviewed September 2015.
Last update September 2015.

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