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Treatment Decisions

Posted 2/7/2014

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  There is something to be said for the old method in which your doctor said "Do X" and you did it. You know, of course, that I don't really mean that, and acknowledge how much better it is that we usually have some choices and should always be included in the decision making. But it can be tough. It is especially difficult when faced with cancer treatment decisions, that may seem like life or death ones (although they aren't), and we are anxious and stressed by the whole experience. Remember what it felt like in the first days or weeks after a diagnosis; it is terribly hard to try to think straight, process a lot of complicated information, and make a wise choice.

  The very earliest decisions are related to choosing a doctor, usually a surgeon, and a hospital. Many things flow from there, but many women do encounter a choice of surgeries, and have to decide what is best for them. I have written a lot about the growing trend of bilateral mastectomies for women who don't medically need that much surgery. I think that choice is sometimes made more from a place of panic than a place of careful thought and understanding.  But the choices can continue: do I need chemo (especially if an Oncotype has been requested, and the score comes back in the gray intermediate range), is there a choice of chemo regimens, what about tamoxifen for DCIS, which hormonal treatment, etc. etc. etc.

  We all have our own styles and needs as we face these decisions. Some women carefully choose a doctor whom they respect and trust and leave the rest to her. Others try to learn as much as possible, seek several opinions, and may still feel overwhelmed and uncertain. It is important to remember that no doctor is going to give you a choice between A that may save your life and B that likely will not. If that were the case, the doctor would most certainly tell you to do A.

  From ASCO's CancerNet comes this excellent discussion. Here is the start and a link:

Making Decisions About Cancer Treatment

• It is important to talk with your health care team so you understand your diagnosis and the recommended treatment plan.
• Learning as much as you can about your options, including the goals of treatment and potential side effects, can help you make informed decisions and know what to expect.
• Talking with family members or trusted friends may help you feel more confident in your treatment decisions.
After a diagnosis of cancer, patients and their families have to make a number of decisions about cancer treatment, some of which are more difficult than others. These decisions are complicated by feelings of anxiety [3], unfamiliar words, statistics, and a sense of urgency. However, unless the situation is extremely urgent, it is important to allow time to research your options, ask questions, and talk with family or a trusted friend.
Decisions about cancer treatment are personal, and you need to feel comfortable with your choices. But, many people don’t know where to start. Here are some simple, but important, steps you might want to take as you start the decision-making


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