Cancer Treatment Decision Making Process: Part 3 of 3

Hi again and welcome to the ongoing conversation. Last blog we reviewed the 2nd of many  “pitfalls” on the road to the control of cancer. We discussed;

#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?

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

This blog we will review –

#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?

First thing to consider is, who is making the recommendation? Be sure that the recommendations regarding radiation therapy are recommendations from a Radiation Oncologist. A Medical Oncologist, or Surgeon should not (cannot) give final recommendations regarding radiation. Patients should know that they have the right to consult with a Radiation Oncologist. But wait – how should a patient know that radiation treatment could possibly be a part of their treatment? Simply ask. Patient’s should not allow themselves to be intimidated. Patient may say,

“Dr. XY, is Radiation Therapy and option for treating any stage of this cancer? If yes, may I have a referral so that I can have a better understanding of my available treatment options from a Radiation Oncologist?”

Simply put … no confrontation.

Let’s think about this from a different angle. Would any patient consider a Heart (Cardiac) Surgeon to operate on their Brain lesion? Certainly not!  Though a Cardiac Surgeon and a Neurosurgeon are both respected surgeons, and may have common knowledge about some of the surgical procedures for each others’ specialty, it does not compute to have recommendations from a Neurosurgeon (Brain) about what a Cardiac Surgeon (Heart) should do about a heart valve replacement. Shiver at the thought! So it is within the oncology (cancer) world.

Usually, the Radiation Oncology treatment recommendations are similar among Radiation Oncologists and they tend to agree on the basic treatment approaches for most cancers. However, as was previously discussed, it is important for patients to understand the basics of the complex topic of Radiation (no degree required – really. Just knowing the questions to ask and engaging your doctor for clarity of concept is a good approach). It is generally common that Multi-Disciplinary clinics or Multi-Disciplinary tumor boards are recommended ( these Multi-D allow everyone on the cancer care team to discuss patient’s cancer diagnosis, treatment plans, etc.,). Take the first step in learning more. In addition to watching the videos on CANCER 101 in the Cancer Courses, here are a few basic questions for your Radiation Oncologist:

  1. Is Radiation therapy indicated for this type of Cancer? (Radiation is not indicated for all cancers. Some Cancers, such as cancer of the blood, like Leukemias {and colon cancers too} are treated with chemotherapy only)
  2. If I have surgery, will Radiation therapy treatments still be recommended? (in some cases, this depends on the final pathology results and how aggressive the cancer appears);
    • Who is a Pathologist? 
    • What makes one cancer more aggressive than the other? 
  3. Is there a type of surgery that would make it possible to obviate (skip) Radiation therapy treatment?
  4. When will I need to have Radiation Therapy in the sequence of my Cancer treatments? Possible answers includes; 
    • Before surgery (as in the case of Rectal Cancer)
    • After surgery (as in the case of Breast Cancer)
    • No surgery recommended but will be combined with chemotherapy (as in the case of unresectable pancreatic cancer)

Then ofcourse, discussion regarding the possible side effects of radiation therapy and understanding how these symptoms may change with combination therapy is also very important. There is usually not a lot of time after a diagnosis to learn about the basics of the cancer, schedule all the various appointments with the many oncologists and supporting services, share with family and love ones, AND make the best decision regarding the treatment plan with your cancer care team while still working and trying to maintain a family. phew … that’s a lot. Remember, adding to that, having more than one consultation is reasonable. However, more than 3 is excessive and may become unproductive and lead to increase stress and worry.

As is now obvious, the above thought processes and line of questionings can quickly take on a life of its own. Advocacy is paramount. A patients must become their own advocate, or have a love one who can do this “job” for them/you! Visit Q4CD for a quick guide on the initial steps.

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

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!

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: