The Cancer Directory. Dr. Daniel Rosy
treatments that might further improve my well-being or chances of survival while having this treatment?
• Does the doctor see any problem with my taking vitamin/mineral supplements alongside the treatment (making sure his or her opinion is a well-informed one)?
• Does the doctor know of any promising ‘medical frontier’ treatments or trials that might offer a better chance of prolonged survival than the treatment I am being offered and, if so, where are these treatments available and at what cost?
Once you are in possession of this information, you will be able to decide whether the side-effects (temporary and permanent) of the treatment outweigh the possible benefits you may receive in terms of symptom improvement and life expectation.
You may find this in-depth questioning of your doctors too difficult to go through. Some people do not want to know exactly where cancer is in their bodies if it is not causing problems nor do they want to pin their doctors down to telling them the exact facts about the effectiveness of the treatments being offered, as this may inhibit their being able to put 100 per cent of their faith in the treatment.
However, I would strongly recommend that, at the very least, you get a clear diagnosis of the primary tumour so that you are certain that you do have cancer, and get some indication of how serious your situation may be. In this way, you can make an informed decision about whether to go ahead with conventional treatment or not with an assessment of the risks involved if you do not feel able to undergo medical treatment.
Thinking about Timing
Next, think about the timing of your treatment. Ask yourself:
• Do I want to go straight into medical treatment for my cancer, or do I need a little time to prepare myself mentally, physically and practically first?
Take the time you need to get yourself in the right frame of mind for treatment. Preparing properly for treatment is covered in detail in Chapter 7.
Understanding the treatment offered
Before you commit to a particular treatment, be sure you understand both the benefits and side-effects that you may experience.
Quite often, because people are so anxious about what the treatment will do in the short term, they do not really hear or take on board what is being said about long-term side-effects. For example, a woman asking about chemotherapy treatment may be thinking about its effects on her hair, nails and energy levels, and whether she will be able to work and look after her children. She may completely miss the fact that, in the longer term, the chemo could cause infertility, depression or nerve damage.
While thinking about the possibility that tamoxifen treatment for breast cancer may cause weight gain, a woman may miss the point that it also carries a 5–10 per cent risk of causing endometrial cancer. Clearly, doctors and other healthcare professionals do not like to dwell on the downsides of treatment but, as mentioned earlier, it is better to be aware of and prepared for the worst-case scenario than having it sprung on you at a later date, facing you with a new set of losses and fears. It may be worthwhile having two separate discussions with your doctors or nurses – one about the short-term effects of the treatment and a blow-by-blow account of receiving the treatment; and another about the possible or likely long-term side-effects of the treatment.
A useful source of information about drug treatments is the drug information centre found in most big hospitals. This is usually staffed by helpful pharmacists, who will take the time to answer your questions or send you printed material about the medicines you are being offered. Pharmacists are far more knowledgeable about drugs and treatments than doctors and other healthcare professionals, and will have detailed information sheets and research data for each medicine being offered at their fingertips. If you do not have access to a big hospital, you can still speak to the pharmacist responsible for the oncology ward who will often be only too pleased to share his or her knowledge and experience with you.
Learning more about the proposed treatment
Make sure that you are asking the right person about the nature of the treatment – the consultant or nurses involved with each aspect of your treatment – and about any relevant details, be it surgery, chemotherapy, radiotherapy or hormone therapy (or any other forms of treatment on offer).
It is then wise to ask yourself if you are satisfied with the information that you have been given, or do you feel the need to seek a second opinion?
When reviewing your options for treatment and before you make your treatment decision, make sure you have collected together all the relevant information by going through the checklist below.
• Options on offer at the hospital in your area
• Range of options on offer at the leading centre of excellence for your particular cancer
• Options that might be available in other parts of the world
• Research trial alternatives
• Alternative cancer medicine choices
• Your integrated medicine complementary and self-help options.
Hopefully, all this information has given you clear guidance on how to find what options are available at your hospital, including getting the opinions of the different specialists mentioned, where appropriate.
If you would like an opinion from a centre of excellence, you need a referral from your GP or consultant. In the UK, it is usually possible to get such an opinion on the NHS if it is clear that the services offered by such a centre are more comprehensive than what is available in your own area. If you have health insurance, check first that your policy covers you for second or third opinions. Treatments in another country are unlikely to be covered by your health insurance, and you should check costs carefully before embarking on this route.
Sometimes, doctors in foreign medical centres are prepared to give an initial opinion of what they can offer you on the strength of letters from your consultants, and having seen your X-rays and/or scans. Because of major advances in digital technology, it is now also possible to send scans to distant locations via e-mail (not to mention by post or courier).
This form of consultation, while lacking the personal touch, can save costly and exhausting trips abroad unless there is likely to be a significant benefit.
How far you wish to go with this process of getting a ‘world picture’ is entirely up to you. For some, this may feel like far too great a burden whereas, for others, it will be a source of great comfort to know that no stone has been left unturned.
Reviewing your alternative cancer treatment options is covered in Chapter 5. A great number of alternative cancer remedies are on offer around the world, with variable levels of information as to their effectiveness. In Chapter 5, you will find:
• basic information on how to use the most well-known alternative cancer medicines
• the approximate cost of their use
• the current level of scientific information about them
• whether you can self-administer them or not (i.e. are they available for sale, by prescription only or clinic-based?).
Reviewing what the complementary medicine and self-help approaches have to offer is the subject of Chapters 7 and 8.