Making Decisions about Cancer Treatment

After a cancer diagnosis, people with cancer and their families have to make a number of decisions about treatment. These decisions are complicated by feelings of anxiety, unfamiliar words, statistics, and a sense of urgency. But unless the situation is extremely urgent, take 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 do not know where to start. Here are some simple but important steps you can take as you start the decision-making process.

Understand your diagnosis

Individual treatment plans depend on the type of cancer and stage. So you should learn as much as you can about your specific diagnosis. You may want to ask your health care team questions about the disease. But be careful when doing research online. Many sites can be frightening, inaccurate, or misleading. Your health care team can suggest trustworthy websites. If you come across unfamiliar words while researching online, use a medical dictionary or ask your health care team for an explanation.

Know your options

Talk with your doctor about the treatment options for your type and stage of cancer. These options may include:

Surgery
Radiation therapy
Chemotherapy
Hormone therapy
Targeted therapy
Immunotherapy
Active surveillance, also called watchful waiting
Palliative care
Participating in a clinical trial

Understand the goals of treatment

Your doctor may use some treatments to slow, stop, or eliminate the cancer. He or she may also use palliative care, also called supportive care, to manage symptoms and side effects. Make sure your doctor explains the goals of your treatment plan and how it will affect you. And make sure it aligns with your personal goals for treatment.

Ask about the side effects of each treatment option

Sometimes cancer can cause long-term side effects, or late effects, that might develop months or even years after treatment. Talk with your health care team about the possible long-term effects of each treatment option and how they are managed. In addition, discuss possible sexual or reproductive concerns with your health care team, including the risk of not being unable to have children. You have more options to keep your fertility if you address this concern before treatment, instead of waiting until after treatment.

Consider the risks and benefits of each treatment option

Weigh the positives and negatives of each treatment option, including the:

Chance of a cure
Potential short- and long-term side effects
Likelihood that the cancer will come back after treatment
Chances of living longer with or without treatment
Effect on your quality of life and independence
Preferences of you and your family

Get a second opinion

Many people seek a second or even third opinion from another oncologist, and many doctors encourage it. Different oncologists may have different experiences with various treatments. So seeking multiple opinions can help you make a decision or confirm your current treatment plan. First check with your insurance company to find out if your policy covers a specific doctor or health care system.

Find help managing the cost of cancer care

The cost of cancer care is often high, and you may have expenses that you were not expecting. Your health care team can help you identify costs related to your treatment options or suggest ways to manage medical and related costs. They can also refer you to support services that address the financial concerns of people living with cancer.

Consult guidelines or other decision-making tools

The American Society of Clinical Oncology (ASCO) and other cancer organizations publish guidelines and treatment decision-making tools. These tools help doctors and patients understand various treatment options. Learn more about treatment recommendations for the specific type of cancer that you have. Talk with your health care team to find out more details about treatment recommendations.

Discuss your decision with people you trust

Some people find it helpful to talk through their thoughts and concerns with people they trust. This may include:

Family members
Friends
A member of the clergy
A spiritual advisor
An oncology social worker
Another person with cancer

Understand the role of statistics

Your doctor may mention statistics when describing treatment options. These may include relative survival rates, disease-free survival rates, and progression-free survival rates. These numbers may be a good way to learn how the treatment options differ. But they cannot predict how well the treatment will work for you. Your health care team can explain how these statistics relate to your treatment.