Thursday, November 15, 2012

The Cancer Decisions

Back in the dark ages of medicine in the 1980s and earlier or so, doctors were gods. They gave us a diagnosis. Told us what our treatment was going to be. We didn't have to make any decisions as our doctors told us what would happen.

Now in 2012, our doctors tell us our options and we make informed decisions based on the advice we have received. That way our wishes are included in the treatment plan...

Wait just a minute here, we have to make informed decisions which means we must do work and figure out what we want? What happened to the easy days of the past where we got to sit around as the patient and be cured without any work?

How are we supposed to make these decisions? What if one of our decisions turned out to have as good an outcome as we wanted? Now our stress level goes up! What to do? What if I was wrong? What if I didn't understand fully all the possible outcomes? Oh, no........

A person with a cancer diagnosis is given treatment options and needs to make decisions which could determine their life span, based on what their doctor tells them and they learn elsewhere. It becomes highly stressful. Should I do chemo, then surgery and then radiation? Or should I opt for radiation followed by surgery? Or should I skip chemo and go straight to radiation? There are too many decisions!

This happens all the time. I see it on message boards everywhere.Also, a doctor has blogged about it on Cancer Realities at WebMD.

Doctors are now encouraged to involve patient wishes in their advice. Patients are becoming more and  more informed. But these decisions can be very difficult to make. A patient can be faced with regrets and fears - "what if I made the wrong decision and it comes back and kills me?" This is an added pressure.

Where I am treated, after my breast cancer diagnosis in 2007, I had a day where I met with the surgeon, medical oncologist, the radiation oncologist, and a social worker. At the end of the day, they came to me with a treatment plan and an explanation of the options they had considered. They wanted my opinion - what I was stressed, shocked, scared, and more -  was I comfortable with their recommendations? I actually felt relatively calm about it as they presented a group recommendaiton to me.

This is a far cry from my  thyroid cancer diagnosis in 1981, the technology wasn't there to help determine whether the lump they felt was cancerous or not. They just told me they were removing it so they could see if it was cancer or not but they really felt because of my age and thyroid cancer's then rarity that it was probably just a goiter.... There was some comfort in being told what to do as opposed to making any decisions.

Do I like making the decisions in my treatment? Yes. But some are definitely easier on my brain than others.

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