Making Decisions About Cancer Treatment

Approved by the Cancer.Net Editorial Board, 11/2013

Listen to the Cancer.Net Podcast: Making Decisions About Cancer Treatment, adapted from this content

Key Messages:

  • It is important to talk with your health care team so you understand your diagnosis and the recommended treatment plan.
  • Learning as much as you can about your options, including the goals of treatment and potential side effects, can help you make informed decisions and know what to expect.
  • Talking with family members or trusted friends may help you feel more confident in your treatment decisions.

After a diagnosis of cancer, patients and their families have to make a number of decisions about cancer treatment, some of which are more difficult than others. These decisions are complicated by feelings of anxiety, unfamiliar words, statistics, and a sense of urgency. However, unless the situation is extremely urgent, it is important to allow 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 don’t know where to start. Here are some simple, but important, steps you might want to take as you start the decision-making process.

Understand your diagnosis. Because individual treatment plans depend on the type and stage of the cancer (where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body), it is important to understand as much as you can about your specific diagnosis. To do this, you may want to research the specific cancer type or ask your doctor questions about the disease. Be careful when doing research online, though. Although there are many excellent resources, there are also sites that are frightening, inaccurate, or misleading. Learn more about evaluating cancer information on the Internet. Also, if you are unfamiliar with some of the words that are used, ask a member of your health care team for an explanation or use a medical dictionary.

Know your options. Talk with your doctor about the treatment options for your type and stage of cancer. Some of these options may include surgery, radiation therapy, chemotherapy, hormone therapy, active surveillance (watchful waiting), palliative care, or participating in a clinical trial. Learning about all of the treatments commonly used for your type of cancer will help you and your doctor form a partnership in your care.

Understand the goals of treatment. Some treatments may be used to slow, stop, or eliminate the cancer (also called disease-directed treatment), while others may be used to manage symptoms and side effects. This second type of treatment, called palliative or supportive care, is an important part of a person’s overall treatment plan and focuses on a person’s emotional and social needs. People with cancer often receive disease-directed therapy and treatment to ease symptoms at the same time.

When making treatment decisions, it is important to not only understand what you can expect your treatment plan to do in your situation but also to make sure it aligns with your personal goals for treatment. For example, someone who values being as comfortable and free from pain as possible may talk with his or her health care team about focusing on palliative care if disease-directed treatment will cause serious or unpleasant side effects.

Ask about the side effects of each treatment option.  Cancer and cancer treatments often cause a variety of side effects. Ask your doctor about the potential side effects you may experience. Sometimes cancer can cause long-term effects, or late effects, that might develop months or even years after treatment has finished. It is also important to talk with your doctor about any potential sexual or reproductive concerns, including the risk of infertility (being unable to become pregnant or have children). 

Consider the risks and benefits of each treatment option. It is important to weigh the positives and negatives of each treatment option, including the chance of a cure or complete remission (no signs of cancer) and the potential short- and long-term side effects. Other factors to consider include the likelihood that the cancer will come back after treatment, the chances of living longer with or without treatment, the effect on your quality of life and independence, and your personal and family preferences. Always keep in mind that any cancer treatment is temporary; you are not committing yourself to a lifetime of a particular medication or therapy.

Get a second opinion. Many people find that it helps to get a second or even third opinion from another oncologist, and many doctors encourage it. Different oncologists may have different experiences with various treatments, and seeking multiple opinions can help you make a decision or confirm your current treatment plan. You may want to check with your insurance company first to find out if a specific doctor or health care system will be covered by your policy.

Find help managing the cost of cancer care. The cost of cancer care is often high, and there may be unanticipated expenses. Your health care team can help you identify costs related to your treatment options, suggest ways to manage medical and associated costs, and refer you to support services that address the financial concerns of people living with cancer. Learn more about managing the cost of cancer care.

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 to help doctors and patients understand various treatment options. In addition, some cancer centers offer sophisticated statistical tools you can use with your doctor to help determine the best treatment option based on your personal medical information. When using treatment guidelines or other tools, talk with your health care team. Doctors can help interpret or determine if these recommendations apply in your situation. Read the ASCO Care and Treatment Recommendations for Patients for easy-to-understand summaries of recent guidelines from ASCO.

Discuss your decision with people you trust. Although any decision about your health care is ultimately up to you, some people find it helpful to talk through their thoughts and concerns with people they trust, such as a family member, friend, member of the clergy, spiritual advisor, oncology social worker, or another person with cancer. Many patient support organizations bring together people who have coped with similar experiences.

Understand the role of statistics. Your doctor may mention statistics when describing treatment options, including relative survival rates, disease-free survival rates, and progression-free survival rates. These numbers may be a good way to learn about how the treatment options differ, but they can’t predict how well the treatment will work for you. Your doctor or another member of your health care team can help you understand how these statistics relate to your treatment. Learn more about cancer statistics.

More Information

When the Doctor Says Cancer

Managing Your Care

ASCO Answers Guides to Cancer

Advanced Cancer Care Planning