Choosing a cancer treatment

Every patient has the right to participate in any decision about their health care or medical treatment. In general, health practitioners are required to inform you of the nature of the proposed treatment and to gain your consent for all treatment, before it starts.

Making a decision about treatment can be complex and frightening, but most people make complex decisions every day. Deciding which car to buy and where to live are also complex decisions, but most people make these decisions successfully many times during their life.

If you are offered a choice of treatments, you will need to weigh the advantages and disadvantages of each treatment. If only one type of treatment is recommended, ask your doctor to explain why other choices have not been offered.

Some people with more advanced cancer will choose treatment, even if it only offers a small chance of cure. Others want to make sure the benefits of treatment outweigh any side effects. Still others will choose the treatment they believe offers them the best quality of life.

Some people may choose not to have treatment to eradicate cancer, but instead will choose to have symptoms managed to optimise their physical and emotional well-being. You may wish to discuss your options with you treatment team, family and friends, or with a counsellor, psychologist or psychiatrist.

Questions you should ask include:

What are my treatment options?

Is this treatment plan meant to help side effects, slow the spread of cancer, or both?

The discussion should include information about any alternative treatment options, including different types of surgery and other treatments. You are also entitled to seek a second opinion.

What are the expected outcomes of each option?

What’s the best we can hope for by trying this treatment? What is the goal?

Successful treatment can never be absolutely assured and different procedures carry different risks. You need to be aware of the expected outcome of the treatment or treatments being recommended, including known complications, so that you can decide which treatment option is best for you.

What is the likelihood that each expected outcome will occur?

What’s the most likely result of trying this treatment?

The likelihood of expected outcomes (success, side effects and/or complications) varies with different treatments and with individual patients’ characteristics. Statistics for success and complication rates are based on studies of large numbers of people with the same stage of cancer. Knowing how likely it is that each outcome will occur will help you and your clinician weigh up the benefits and risks.

Some procedures that are new or uncommon may not have sufficient research to support meaningful statistics and your doctor will make recommendations based on other information, such as personal experience, training or expert knowledge. Where your doctor is relying on alternative information they should discuss this with you.

What are the possible side effects and other downsides of the treatment?

How likely are they? Are the possible rewards bigger than the possible drawbacks?

Doctors and other health practitioners know a lot about the treatments they recommend, but only you know about your lifestyle, the demands of your job and family and your personal needs and preferences. You will need to weigh the impact of the treatment against its likely outcome.