Some treatment decisions must be made quickly, and others can be delayed while you consider what’s best for you.

• Some people will have different treatment options to choose from and others won't.

• You have a right to a second opinion.

• Your specialist might not offer you the right options, especially if they don't know you're LGBTQ+ or know how to support LGBTQ+ bodies

• Some people will choose not to have treatment.

Read more about treatment at eviQ.

Cancer treatment can have lasting impacts even after treatment on your body, your senses and your sexual expression (whatever that means to you). Read more in: intimacy and sexual function. 

Here we include some general questions. 

Asking these questions (and other questions you have) of health providers and people with lived experience of cancer can help. 

Your health providers might not understand the specific ways treatment will impact you. LGBTQ+ people with lived experience of the same treatment often have unique insights which might give you a better understanding of what to consider and what may happen. You might find information from friends and family, in online forums, in support groups or somewhere else. 

Some specialists might make assumptions about what’s best for your body and not the choices you need. You have the right to a second opinion. Read more in your rights.

If you don’t have the capacity to find information, ask others to help you (if you can). 

• Do I have choices in my treatment? 

• What can I expect to happen to my body and mind as a result of this treatment? 

• How is my life going to change? 

• What is the medication I’ve been prescribed and how does it work?

• What would happen if I didn’t get this treatment?

Cancer can put pressure on relationships.

Some relationships grow stronger through cancer while other relationships might be lost.

Care can come in many forms. From:

• friends and family

• from other people going through cancer (see: community support)

• from ourselves (self-care and self-soothing)

• from the broader LGBTQSGBB community

• from Country, culture or faith

• from the medical system (including complementary therapies

or from somewhere else

Everyone’s experience is different. And, we know that some people will face isolation and a lack of care from the people around them.

drawing on the strengths of others 

Our communities have rich histories of mutual aid, resource sharing, care-giving outside the medical system and leaning on each other when we need support. People in your life may want to help and have energy to help you. They might not know how to help (see: for carers, friends and supporters.) We also heard that connecting with others with lived experience of cancer can really help, during treatment and after (see: community support).

If you can access a GP or other healthcare provider you can trust, this person can help manage your medications, get you referrals, manage side effects. Between you, hospital + specialists. You might want to book a regular appointment with them throughout your treatment.   

navigating romantic relationships and caregiving 

There’s often an assumption that your partner/s will be your carer/s through treatment. 

It might be useful to have a conversation about:

• what they can and can’t do

• the other kinds of support you might be able to draw on 

choosing who you tell and how 

Some people will choose to tell just a few people they have cancer, while others tell many people. Some treatments will change the way you look and feel, so you might want to explain that to your people so they can understand what you’re going through. Telling some people in your workplace might be important to access leave and other accommodations. Read more in: choosing how to tell and how

Treatment has many impacts that will vary from person to person.

Here we share some broader impacts and then impacts generally experienced through different forms of cancer treatment. The Cancer Council explains treatment impacts here and here.

There’s no one way to look sick. Not experiencing hair loss, or visible signs of treatment can leave people feeling invisible. On top of medical stress, many people experience financial stress from not being able to work, or needing to work a lot less. 

You might experience...

• Emotionally, feeling angry, shocked, resentful, sad, numb and experiencing ongoing grief and dysregulation.

• Mentally, finding it hard to concentrate, to remember information, to read.

• Relationally, the dynamics in romantic and other relationships can change. You may feel isolated from people, even loved ones, who haven’t experienced cancer. 

• Physically, experiencing tiredness, finding it hard to get out of bed, having a dry mouth

• Socially, some people might become more isolated from others, including queer communities. Friends and family might be scared to talk about what you’re going through which can lead to more isolation. 

• Spiritually, your beliefs might change or be challenged, you might experience the world and time in a new way and develop new beliefs.

Here are three things that might happen for main treatment types. 

chemotherapy (chemo) 

1. Nausea/vomiting. It can feel like a combination of seasickness and being hungover. The degree of nausea you experience can depend on the type of chemotherapy you are receiving. 

2. Loss of appetite or sense of taste. Some people mentioned craving fresh/textured food. Some people described craving salty/ fatty food. Some lost interest in foods they previously liked.

3. Hair loss. This will also vary depending on the type of chemo. Shans hair loss story here. Some folks might like to wear a scarf, beanie or hat. Link to how to tie scarf and how to knit beanie here. For more information about chemo visit xxxx 

radiation

1. Fatigue. Generally the fatigue related to radiation treatment increases over time. You may not feel much different over the first couple of weeks but as your treatment continues you might start to become more and more lethargic. Needing lots of time to rest or sleep

2. Skin or tissue damage. Depending on where on your body you are receiving treatment, prolonged radiation treatment can cause severe burns, broken or weeping skin and long term changes in the colour, elasticity and sensitivity of the area. Some more severe impacts can occur like damage to the teeth and mouth in throat cancer, cording or freezing of muscles when the chest is radiated which might require physiotherapy. 

3. Fertility and sexual function. In radiation for the pelvis and rectum there may be a loss of sexual function and an increased risk of infertility. For more information about radiation visit xxxx 

immunotherapy

1. Muscle, joint and bone pain. This may vary in severity depending on the type of therapy you are receiving. You might need pain killers to manage this symptom which your oncologist should be able to prescribe you. Some people had success managing their pain with CBD oil. 

2. Fatigue. This will also vary depending on your reaction to the particular therapy you have been prescribed. Most people talked about fatigue increasing for 2 or 3 days after their dose and then dissipating. 

3. Inflammation. The parts of your body and the severity of the inflammation can vary. Some people spoke about dealing with hyperthyroidism. This can usually be treated with medications. For more information about immunotherapy visit xxxx

Support looks different for everyone, for some people it might be having space away from people, for others, it might be having people around all the time. You might not choose to tell anyone about your cancer. Read more: choosing who to tell.

It’s okay to need help, ask for help and receive help. 

You might not know what you need, or have energy to think about that. So it’s helpful for your people to offer specific things they can do (see: for carers, friends and supporters).

There are affirming health providers (see Transhub Doctor list or AusPATH practitioners). And, trans and gender diverse (trans) people often face extra challenges accessing care that consistently uses our correct name, pronouns, gender and offers relevant choices for our bodies.

We know some trans people:

• won’t have a choice about being out to health providers during treatment

• don’t use or don’t plan on using gender-affirming hormones, or want surgical intervention(s) to affirm their gender while others do

Some cancer treatments might be gender-affirming, for example, needing a mastectomy for breast cancer. Even with gender-affirming changes, you might still experience grief and sadness alongside gender euphoria and other emotions. You might not be able to access your choice of gender-affirming treatment options because of the kind of cancer you have, the type of surgery you need, or, due to a lack of services.

You might ask: 

• How will this treatment impact my gender-affirmation during and after treatment? 

• What is the best team/service/facility/ward based on who I am?
  for example, a trans man might not want to receive treatment at a  women's hospital, a trans woman might not want to be at a prostate cancer clinic with cisgender men 

• What are my options?

• Can you refer me to a specialist who does gender-affirming treatment options?

hormones 

Cancer treatment can impact hormones and interact with gender-affirming hormone treatment. If you’ve been diagnosed with hormone receptor-positive cancer, or want to better understand the relationship between gender-affirming hormones and your cancer treatment, it may be useful to have an appointment with your GP and an endocrinologist.  There is currently limited research or data around how hormone-based treatments and medications interact with gender affirming hormones. It may be difficult or you may not be able to access the information or advice you need. In this case it might be helpful to ask other people with lived experience. If you’re aware of research or resources, we’d love to hear from you.

surgery 

For trans people considering or receiving treatment, you may want to ask about treatment impacts on gender-affirming hormones (short and long-term) as well as surgical options that align to who you are. For people with breast cancer, for example, you might be recommended a lumpectomy and instead want a double mastectomy. 

If you have a surgically created vagina (vaginoplasty), speak to your doctor about the effects of radiation therapy.  

Some surgeons may welcome a discussion about surgery that affirms who you are, while others might not have enough knowledge or not be open to talking about it. You have the right to seek a second opinion. Read more in: your rights. 

However you respond to a cancer diagnosis is valid. 

You might disassociate or feel numb. You might get angry or sad or all of the above. You might want people around you or you might need space. You might adjust to the news in time. You might not adjust at all. It’s all okay. 

When we dissociate the initial processes can seem to go by in a blur. This is when it can be especially helpful to have someone with you at your appointments to record or write down important information.  

Often decisions will be made quickly and treatments will begin soon after diagnosis. You might feel like you don’t have time or space to ‘feel’ the changes that are happening to you. It can be like a rollercoaster that you can’t get off or a movie that you can’t press pause on.  

Cancer can be profoundly isolating. Like you have gone to planet cancer and you can’t get off. Others can visit you but you can’t leave. You might ask your people to find accessible ways to spend time with you and keep you included, even when you can’t leave the house (see: for carers, friends and supporters.) 

Grief in cancer can exist outside of facing the end of life or losing a loved one. There is grief in the loss of body parts, changes to our lifestyle and bodies (see body image and identity) or our ability to work in our chosen profession. There can be grief in the loss of friendships or relationships due to your cancer experience. There can be a feeling of grief for the person you were before your diagnosis as you realise who you are, now that you are living with cancer, is different. Some people might not experience feelings of grief at all. 

While some people might become more connected with queer community through their cancers, others might become more isolated and find themselves in predominantly non-queer spaces.