Before Treatment: Making Medical Decisions

March 29, 2013
CURE, Cancer Guide 2014, Volume 0, Issue 0

Six steps for handling the stress of choosing treatment 

The doctor-patient relationship has changed. In times past, patients willingly went along with whatever their physician recommended with few questions. Today, patients no longer simply follow doctors’ orders without wanting to know why, how and if. There are new rules for both patients and physicians. Patients are driving their medical decisions in partnership with their healthcare team. It’s not easy, due in part to the ever increasing number of treatment options available.

For some people, the right choice is treatment with a goal of cure, regardless of the chance for cure (as long as there is some chance) and regardless of the risks and costs of treatment. For others, cure is not the best route because the chance for cure is very low, and the price (discomfort, travel, expense, risk of death or complications) is too great.

Doctors can provide patients statistical data for each treatment option regarding chances of remission, cure rates, complications, side effects and death. They may even be able to give some idea of what the treatment experience will be like. Survivors who have been through similar treatments can usually provide insight into the experience, and doctors can refer patients who are willing to share their experience and advice.

[Questions to Ask]

As patients weigh their options and discuss them with their doctor, they should consider these steps.

UNDERSTAND THE OPTIONS. Patients shouldn't try to decide which choice is best at the time they receive their diagnosis—just identify as many options as possible, even if some seem far-fetched. Research indicates that most patients want complete medical information from doctors and to share the decision-making authority to create a true partnership. Different doctors might recommend different chemotherapy combinations 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."

KNOW THE TRADE-OFFS. Once patients have a list of options, they should weigh the positives and negatives about each one. The best information is quantitative, such as chance of recurrence in five years or risk of certain side effects. The goal is to know the risk versus the benefit of each option.

INVESTIGATE THE DATA. Patients should find out as much as they can about each option by talking with their doctors and doing research. For a crash course in any cancer, news of cutting-edge treatments and advice and support from online cancer communities, visit or

BE SKEPTICAL. Patients should make sure the resources they check are credible.

CONSIDER THE MEANING. Each medical decision means different things to different people. Patients should understand the meaning a medical decision has not only for their quality of life but also for how it will impact their loved ones.

ACT WITH CONFIDENCE. 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 carries a measure of uncertainty. Patients soon come to understand what oncologists have always known: The treatment may or may not be effective. But in all cases, it is important that patients make decisions with confidence, knowing that they are making the wisest choice they can at that time.

[Words of Wisdom]