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Cancer treatment decisions: 5 steps to help you decide

Helping your doctor make decisions about your cancer treatment may make you feel more confident as you begin your cancer treatment. Find out how to get involved.

By Mayo Clinic staff

You've just been diagnosed with cancer. Your mind is reeling. And now your doctor wants you to sort through the data and weigh in on a cancer treatment plan.

But how do you decide upon a cancer treatment plan? Here are five steps to guide you in working with your doctor to make a decision about your cancer treatment.

Step 1: Set your ground rules

Before exploring treatment options, establish some ground rules. You'll be more comfortable with any cancer treatment decisions you make if you:

  • Decide how much you want to know. While most people want to know exactly what their treatment is and their survival chances, others don't. If you don't want to know all the details, let your doctor know, and you and your doctor can devise a strategy that's appropriate for you.
  • Decide how you'll want to make your treatment decisions. You might want to gather all the information you can and take the lead in the decision-making process. Or you might want to turn all decisions over to your doctor. You might also be somewhere in the middle, sharing the decision process with your doctor.
  • Have realistic expectations. Your doctor can give you estimates about what you can expect to get from each type of treatment. But what you do with these estimates is up to you. Exactly what side effects you may be willing to put up with will depend on what the benefits of the treatment are likely to be. Communicate your preferences with your doctor.
  • Keep the focus on you. Don't let anyone pressure you into a particular treatment option. Pick what you feel most comfortable with.
  • Accept help. You'll need support throughout your treatment. Support can come from your doctor, your friends and your family. If you don't feel supported in your decision making, contact groups such as the American Cancer Society, which can put you in contact with cancer survivors who can help support you through this process.

It might help to write down your expectations and preferences before you meet with your doctor. That might help you better express your hopes for and feelings about your cancer treatment.

Step 2: Decide on a goal

What do you want out of treatment? A cure, stabilization or solely symptom relief? Deciding what you want out of treatment will help you narrow your treatment choices. Depending on your cancer type and stage, your goals for treatment might be:

  • Cure. When you're first diagnosed, it's likely you'll be interested in treatments that cure cancer. When a cure is your goal, you may be willing to endure more short-term side effects in return for the chance at a cure.
  • Control. If your cancer is at a later stage or if you've tried unsuccessful treatments, you might adjust your goal to controlling your cancer. Different treatments may attempt to temporarily shrink or stop your cancer from growing. If this is your goal, you might not be willing to endure the side effects of harsher treatments.
  • Comfort. If you have an advanced stage cancer or one that hasn't responded to treatments, you might decide that comfort is most important to you. You and your doctor will work together to make sure you are free of pain and other symptoms.

Step 3: Research your treatment options

To make a reasonable treatment decision, keep in mind the type of cancer you have, its stage, and what treatment options are available and how likely these treatments are to work under these circumstances. Talk to your doctor about Web sites, books and patient education materials to supplement your discussions.

The treatment you start with is known as primary therapy. Most people receive chemotherapy, radiation, surgery or a combination of any of these three as their primary therapy.

Cancer treatments are sometimes used in conjunction with each other. For example, it's common to pair surgery or radiation with chemotherapy. Doctors sometimes refer to a treatment that's used after the primary treatment as an adjuvant therapy.

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References
  1. Cancer self-advocacy. Cancer.Net. http://www.cancer.net/patient/Library/Cancer.Net+Features/Living+With+Cancer/Cancer+Self-Advocacy. Accessed Oct. 20, 2008.
  2. Zafar SY, et al. Decision making and quality of life in the treatment of cancer: A review. Supportive Care in Cancer. In press. Accessed Oct. 20, 2008.
  3. Blank T, et al. Understanding treatment decision making: Context, commonalities, complexities and challenges. Annals of Behavioral Medicine. 2006;32(3):211-217.
  4. Moynihan TJ (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 11, 2004.
  5. Creagan ET (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 5, 2008.

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Dec. 2, 2008

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