Choosing the best treatment for cancer may be challenging and difficult. Patients should be well informed before making their choice. Communication between the patient and family and their medical team including their physician is very important.
The medical team should describe the available treatment choices to the patient and the expected results of each of them as well as their possible side effects. Patients should carefully consider the available options and understand how these treatment modalities may affect their functions, general health, appearance and livelihood. The patient and his/her health care team can work together to develop a treatment plan that fits their needs and expectations.
When facing a new medical diagnosis that requires making a choice between several therapeutic options including surgery it is important to get a second opinion. There may be different medical and surgical approaches to care for a patient and a second (or even third) opinion may be invaluable. Getting such an opinion from physicians who are experienced in the issues at hand is wise. There are many situations where treatment cannot be reversed. This is why choosing the course of therapy after consulting with at least one more specialist is very important.
Some individuals may be reluctant to ask for a referral to see another physician for a second opinion. Some may be afraid that this will be interpreted as lack of confidence in their primary physician or doubts about their competence. However, most clinicians welcome and encourage the practice and many medical insurers welcome it.
Patients are often stressed and anxious when they learn that they suffer from a serious illness and may not be able to integrate all the information and explanations they hear. They may therefore need to hear these several times to understand and integrate the information. Having a patient advocate (family member or friend) attend the discussions with the medical team is desirable as they can assist the patient in making the correct choice.
These are some of the questions to ask one’s physician(s) that can assist in making the correct choice:
- What is the size, location, spread, and stage of the tumor?
- What are the treatment options?
- Would they include surgery, radiation therapy, chemotherapy or a combination of these?
- What are the expected side effects, risks and benefits of each kind of treatment?
- How can side effects be managed?
- What is my chance of preserving normal functions and activities with each of the above treatments?
- How to prepare for treatment?
- Will the treatment require hospitalization and if so for how long?
- What is the estimated cost of the treatment and will insurance cover it?
- How will treatment affect one’s life, work and normal activities?
- Is a research study (clinical trial) a good option?
- Can you recommend an expert for second opinion regarding the treatment options?
- How often and for how long will there be a need for follow ups?
Hopefully these measures will assist the patient in making the best treatment choice.
Itzhak Brook is a professor of pediatrics, Georgetown University School of Medicine and author of the book My Voice: A Physician’s Personal Experience With Throat Cancer and In the Sands of Sinai: A Physician’s Account of the Yom Kippur War. He blogs at My Voice.