Six steps for handling the stress of choosing treatment
Patients today are breaking the old-school rules of the doctor-patient relationship. Once upon a time, patients dutifully followed doctors’ orders. But in the past few decades, rules—and roles—have changed. A growing number of patients make all matters of medical decisions in partnership with their doctors, from which treatment to pursue to how to cope with side effects. But as anyone who has had a medical problem can tell you, it’s not easy. Medical science has created so many options that it’s difficult to pick the best one. As you weigh your options, here are six steps that may help.
Step 1. KNOW YOUR OPTIONS. Don’t try to decide which choice is best at this point—just find as many options as you can, even if some seem far-fetched. Research shows that, in general, patients want to receive complete medical information from doctors and share the decision-making authority with them to create a true partnership. Different doctors might recommend different chemotherapy cocktails at different intervals or different combinations of chemotherapy, surgery, and radiation. Then again, the best treatment may be no treatment at all. Patients diagnosed with slow-growing cancers are often given the option of “watchful waiting” if there are no serious symptoms.
Step 2. LEARN THE TRADE-OFFS. Now that you have a list of options, find out the good and bad about each one. Try to get quantitative information, such as chance of recurrence in five years or risk of certain side effects. The goal is to know the pros and cons of each option in order to make a good decision.
Step 3. DISCOVER THE DATA. Find out as much information as you can about each option. Talk with your doctors, and don’t be afraid to do research. A librarian can guide you to medical textbooks and articles. You may not understand every word, but the books contain valuable information. The Internet can offer a crash course in any cancer, news of cutting-edge treatments, and advice and support from online cancer communities.
Step 4. BE SKEPTICAL. Make sure your sources are credible. For example, find out which companies sponsor the websites you are using. If you are reading about a particular treatment, make sure the patients treated have the same type of cancer you have. Is the treatment recommendation based on success in one patient or in a randomized trial of 1,000 patients?
Step 5. CONTEMPLATE THE MEANING. Each medical decision means different things to different people. The decision to undergo surgery to relieve back pain might be obvious to a 56-year-old man with a large family. But an 82-year-old man who is the sole caretaker of his ill wife might choose to endure pain rather than take the risk that surgery would prevent him from caring for his loved one. Find the meaning your medical decision has for you and your life.
Step 6. BE CONFIDENT. It can be a tremendous relief for both patient and doctor once they settle upon a treatment plan, but in the world of cancer, each decision nevertheless carries a measure of uncertainty. You will come to understand what oncologists have always known: The treatment may or may not be effective. But in all cases, it is important to make decisions with confidence.
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