Cancer Patient Guide

[ Cancer Treatment ]

Selecting a Therapy

Consider the risks and benefits based on your own values. Carefully consider your age, health, and personal desires. Each decision for treatment must be based solely on what you think is best for you.

If all the doctors you’ve consulted agree on a particular treatment, your decision may be clear. If they do not agree on the treatment, ask them to discuss your disease with one another and develop a clear recommendation for treatment. If they cannot agree, it is probably because there is more than one equally effective therapy. When the scientific literature reports only a small difference in the results among treatments being offered, there is little likelihood of one treatment having a real advantage in any particular case. Choosing the therapy when no treatment has a clear advantage is very difficult. There may not be a single correct answer. When the choice is entirely yours, it is equally valid to:

  • Make your decision based on personal and individual reasons such as side effects, preferable cosmetic results, or risk of dying from the selected procedure.
  • Follow the advice of the doctor with the most experience in your cancer.
  • Seek another opinion.
  • Join a clinical trial (a medical investigation) that is trying to find out which treatment is best. Participants in clinical trials are randomly assigned to the “best standard treatment” or the investigational treatment that doctors hope is an improvement.

Getting Additional Opinions

You have the right to obtain copies of all your test results. You should have copies of the written reports unless your doctor has already sent them to the person from whom you are seeking a second opinion. Your doctor may wish to have you transport the actual images to the doctor for the second opinion as well.

You or your doctor can arrange second opinions. You may want a second opinion to confirm the original diagnosis; help identify the primary site of cancer if it has not yet been found; help identify or choose among treatment options; or make yourself more comfortable with your doctor’s initial recommendations.

To arrange a second opinion, you can contact a number of sources. Ask your oncologist or primary care physician for a recommendation. Call your county medical society for the names of specialists, or call a teaching or university hospital. The Bay Area Tumor Institute also has a list of physicians participating in clinical research.

A tumor board is a group of cancer specialists who meet to discuss treatment options and coordinate a patient’s care. These consultations may or may not be free. Ask your physician if you would benefit from a tumor board presentation at your hospital or at a university referral center. Your doctor should be willing to set up such a presentation for you if there are any possible alternatives to the recommended therapy. You may be asked to be present for a portion of the tumor board presentation; if so, you are free to accept or refuse this invitation, but it may be helpful to you and to the medical staff who are evaluating your options for you to be present.

When to Go to a University or National Cancer Institute - Approved Comprehensive Center

Before thinking about going to a university or NCI-approved cancer center, you should know that most common cancer cases can be treated as successfully, and perhaps more comfortably, in your community hospital if the appropriate cancer specialists are available.

If you have been told you have a rare cancer or an unusual presentation that requires highly specialized equipment, or physicians with specialized training who are not available in your community, you should go to a specialized cancer center.

Getting Rehabilitation

Cancer and its treatment can lead to changes in physical ability. As rapidly as possible, you want to get back to your normal activities with your family, job, friends, and hobbies. Talk to your doctor and nurses about physical, occupational, or speech rehabilitation.

Considering Complementary Therapy

There is no scientifically documented proof that nutritional therapies, acupuncture, homeopathy, aromatherapy, Eastern medicines, or other alternative therapies will cure or help treat cancer. This is not to say they should not play a role in your cancer treatment. If you are interested in complementary therapies, be sure to inform all of your doctors so that the different approaches can be coordinated for you.

When considering complementary treatment options, here are some questions to ask the practitioner:

  • What is the main focus of the treatment?
  • Has this treatment been evaluated in scientific trials? If so, in which scientific journals was it reported?
  • What training and experience in these areas do you, as a practitioner, have?
  • How much will the treatment cost? Will my insurance company pay?

Be cautious if the practitioner claims the treatment is harmless and painless. Most successful treatments are very powerful and may have unpleasant side effects. Also, does the treatment have a secret formula known only to the provider? Reputable scientists and medical professionals have no secrets.

What to Avoid

Don’t allow yourself to be financially and emotionally exploited by doctors or others who say the medical establishment “persecutes” them, or by anyone who offers either a “magic cancer cure” or expensive “cures” found only in faraway places.