Cancer Treatment Decision Making Process: Part 1 of 3

Pain Management

The “C” word is horrible.

Cancer is horrible and scary.

A second opinion after a diagnosis of Cancer is reasonable and is usually recommended. Oncologist are no offended by this (well, they should not be) especially if a patient is uncomfortable with the diagnosis, uncomfortable with doctors and/or hospital. A second opinion provides reassurance for the patient that they are doing everything they can to receive the best care.  However, friends have relayed frustration, because even after a 3rd opinion full grasp of the concept of the disease still evades them. It is important that in preparation for the cancer treatment journey, patient learn how to become their own advocate, or be an advocate for a love one.  Time is usually of the essence and reading a lot of information on a new topic such as cancer, under pressure, can quickly become overwhelming. For this reason, the Cancer Courses are usually a good start for patients newly diagnosed with cancer – majority of the information was compiled using videos patients finds it very user friendly.

Let us take the time to review 3 of many possible scenarios, on the road to cancer control…

  1. Hospital X is famous for Pancreatic Cancer treatment but is located 500 miles away from your home, family, friends and support systems. What will you do?

In the Oncology community, it is believed that Surgical Oncologists, not just any Surgeon, should perform Cancer surgeries. A Surgical Oncologist is a surgeon who specializes in cancer surgery.  For example; a general surgeon who perform mostly appendectomies, gallbladder removal, etc., should not perform the surgery for Pancreatic Cancer (known as Whipple or pancreaticoduodenectomy).  In this major surgery, a portion of the pancreas, the gallbladder, bile duct, and portions of the small intestine, stomach, and pancreas are removed and regional lymph nodes are also removed to assess if the Cancer has spread.  This would be called an “Oncologic Surgery” and different types of “Oncologic Surgeries” are performed for different Cancers.

There are many pit falls to having a major surgery performed at a distance location (and conversely for having the surgery closer to home). Some large medical centers, or cancer hospital systems may be able to make provision for lodging close to the hospital for before and after surgery care. Consider family and friend support, follow-up plan and personal care in the decision making process.  Will someone be able to travel and stay with you at a distant location? For how long? What about after the surgery? Will the follow-up appointments be at the distant hospital? What if there are complications upon returning home? Who and how should this be handled? Be sure to explore all your options, and understand the plan best you can, if time permits.

If the distant hospital is the most optimal scenarios, patients are strongly encouraged to explore options with the Surgeon at the distant hospital AND the local Surgeon BEFORE any surgery is perform. It is imperative (and the patient’s right) to have both Surgeons communicate and formulate a plan together AND explain the plan of action before any treatment begins.  We are in the technology age and there are many communication methods. Communication should not be an issue and patient’s request should not delay treatment. If at all possible, patients should have a plan of action in hand to share with family and friends and review and discuss before any treatment begins. As it is often said, “Doctor shop before, not during, cancer treatment.”

Remember, it is your life and you must  become your own advocate!

The remaining 2 points will be discussed in the following blogs. What are your thoughts?

2. Hospital Virginia recommends a different type of surgery from Hospital Maryland. Which surgery should you choose and why? Are there guidelines?

3. Hospital Q in DC Oncology team recommends Radiation Therapy but Hospital V in Delaware said Radiation Therapy is not necessary. How should you approach this differing opinion?

Until next time,


Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit our website … HERE

Queen, Your Family Friendly Cancer Doc!

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