Handling the Diagnosis
It is natural for anyone facing cancer to be concerned about what the future holds. Understanding the nature of cancer and what to expect can help patients and their loved ones plan treatment, anticipate lifestyle changes, and make financial decisions. Cancer patients frequently ask their doctor or search on their own for statistics to answer the question, "What is my prognosis ?"
Prognosis is a prediction of the future course and outcome of a disease, and an indication of the likelihood of recovery from that disease. However, it is only a prediction. When doctors discuss a patient's prognosis, they are attempting to project what is likely to occur for that individual patient.
A cancer patient's prognosis can be affected by many factors, particularly the type of cancer, the stage of the disease, and its grade (how closely the cancer resembles normal tissue and how fast the cancer is likely to grow and spread). Other factors that may also affect the prognosis include the patient's age, general health, and response to treatment.
As these factors change over time, a patient's prognosis is also likely to change. Sometimes people use statistics to try to figure out their chances of being cured. However, for individual patients and their families, statistics are seldom helpful because they reflect the experience of a large group of patients.
Statistics cannot predict what will happen to a particular patient because no two patients are alike; treatment and responses vary greatly. If people want prognostic information, they should talk with the doctor. The doctor who is most familiar with a person's situation is in the best position to help interpret statistics and discuss prognosis.
But even the doctor may not be able to describe exactly what to expect. Seeking information about prognosis and statistics can help some people reduce their fears. How much information to seek and how to deal with it are personal matters.
Treatment for cancer depends on the type of cancer; the size, location, and stage of the disease; the person's general health; and other factors. The doctor develops a treatment plan to fit each person's situation. People with cancer are often treated by a team of specialists, which may include a surgeon, radiation oncologist , medical oncologist , and others.
Most cancers are treated with surgery , radiation therapy , chemotherapy , hormone therapy , or biological therapy . The doctors may decide to use one treatment method or a combination of methods.
Clinical trials (research studies) offer important treatment options for many people with cancer. Research studies evaluate promising new therapies and answer scientific questions. The goal of such trials is to find treatments that are more effective in controlling cancer with fewer side effects.
Getting a Second Opinion
Before starting treatment, the patient may want to have a second opinion from another doctor about the diagnosis and the treatment plan. Some insurance companies require a second opinion; others may cover a second opinion if the patient requests it. There are a number of ways to find a doctor who can give a second opinion: The patient's doctor may be able to suggest specialists to consult. The Cancer Information Service, at 1-800-4-CANCER, can tell callers about cancer treatment facilities all over the country, including cancer centers and other programs supported by the National Cancer Institute.
Patients can get the names of doctors from their local medical society, a nearby hospital, or a medical school. The Official ABMS Directory of Board Certified Medical Specialists lists doctors names along with their speciality and their educational background. This resource, produced by the American Board of Medical Specialties (ABMS), is available in most public libraries.
The ABMS also provides an online service to help people locate doctors at www.abms.org.
Preparing for Treatment
Many people with cancer want to take an active part in decisions about their medical care. They want to learn all they can about their disease and their treatment choices. However, the shock and stress that people often feel after a diagnosis of cancer can make it hard for them to think of everything they want to ask the doctor.
Often it is helpful to prepare a list of questions in advance. To help remember what the doctor says, patients may take notes or ask whether they may use a tape recorder. Some people also want to have a family member or friend with them when they talk to the doctor -- to take part in the discussion, to take notes, or just to listen. These are some questions a patient may want to ask the doctor before treatment begins:
- What is my diagnosis?
- Is there any evidence the cancer has spread?
- What is the stage of the disease?
- What are my treatment choices?
- Which do you recommend for me? Why?
- What new treatments are being studied?
- Would a clinical trial be appropriate for me?
- What are the expected benefits of each kind of treatment?
- What are the risks and possible side effects of each treatment?
- Is infertility a side effect of cancer treatment? Can anything be done about it?
- What can I do to prepare for treatment?
How often will I have treatments?
- How long will treatment last?
- Will I have to change my normal activities? If so, for how long?
- What is the treatment likely to cost?
Patients do not need to ask all their questions or remember all the answers at one time. They will have many chances to ask the doctor to explain things and to get more information.