A lack of understandable and easily available information on prognosis, treatment options, likelihood of treatment responses, palliative care, psychosocial support, and the costs of cancer care contribute to communication problems, which are exacerbated in patients with advanced cancer. 1
Full Answer
How to make decisions about cancer treatment?
Making Decisions About Cancer Treatment 1 Understand your diagnosis. 2 Know your options. 3 Understand the goals of treatment. 4 Ask about the side effects of each treatment option. 5 Consider the risks and benefits of each treatment option. 6 ... (more items)
How do patients with advanced cancer prefer cancer treatment?
Seventy-two percent of patients with advanced cancer preferred treatment focused on comfort, answering affirmatively to the question, “If you could choose, would you prefer a plan of care that focused on relieving pain and discomfort, even if this meant not living as long?”; 28% preferred life-extending treatment.
Why is cancer such a good target for decision support?
Prevention and treatment of cancer are particularly good targets for decision support for several reasons. First, as noted earlier, cancer accounts for a significant amount of morbidity and mortality. Second, fear of cancer is high among the general public and perception of cancer risk often exceeds its true level.
Is there an evidence-based basis for cancer decision making?
Although empirical phenomena relevant to cancer decision making have informed theories, these evidence-based theories have not become the basis for decision aids, despite their clear relevance.
What factors influence treatment decision making for cancer?
Patient-centered Factors that Affect Cancer Treatment Decision-MakingPatient's beliefs and values.Ethnicity.Decisional control preferences.Health related experience.Patient's perception of the decision-making process.Personal factors.
What are the 4 goals of cancer treatment?
There are four main goals for chemotherapy:Curative therapy to kill all cancer cells.Adjuvant therapy which targets cells left after surgery to prevent recurrences.Neoadjuvant therapy to shrink tumors before surgery.Palliative therapy to give relief when not possible to remove all tumor cells.
What main factors do doctors consider when deciding on the cancer treatment options?
Some aspects you'll want to consider for each treatment include:Side effects. Take time to review the side effects of each treatment and decide whether they'll be worth enduring or too much to handle. ... How treatment affects your life. ... The financial costs of treatment. ... Your health in general.
How do you make a cancer treatment decision?
Know all treatment options. Talk about the details of each treatment option with your cancer care team. Learn as much as you can and understand the information being given to you. Are a partner with your doctor in making treatment decisions and planning your care.
What is the main goal of cancer treatment?
The goal of a primary treatment is to completely remove the cancer from your body or kill all the cancer cells. Any cancer treatment can be used as a primary treatment, but the most common primary cancer treatment for the most common types of cancer is surgery.
What are the 3 possible goals of cancer treatment?
The goals of cancer treatment include eradicating known tumors entirely, preventing the recurrence or spread of the primary cancer, and relieving symptoms if all reasonable curative approaches have been exhausted.
What should a doctor consider before deciding on a treatment option?
When making any treatment decision, you should consider the risks, benefits, and supporting evidence for the treatment. In addition, you should consider if the treatment is compatible with your personal values and preferences and if it is accessible at a reasonable cost.
How do oncologists decide treatment?
The patient's preference is increasingly considered as one of the main factors that determines which of the available treatment options will be included in the decision-making process. The choice of the best treatment option for a given patient depends on the patient's values and preferences.
What is a treatment decision?
Treatment decision making (TDM) is complex due to the varying decisions which have to be made about diagnosis, treatment options, toxicity, and outcomes of treatment. Shared decision making is complicated by the triadic relationship of parent/caregiver, child and clinician typical in pediatric care.
What are the treatment options for cancer?
Some people with cancer will have only one treatment. But most people have a combination of treatments, such as surgery with chemotherapy and/or radiation therapy. You may also have immunotherapy, targeted therapy, or hormone therapy. Clinical trials might also be an option for you.
How do you write a treatment decision?
Tips to help you make a decisionMake a list of your options. Write down the names of the treatment options that your healthcare team recommends. ... Get information about each option. ... Think about what's important to you. ... Talk it over. ... Take some time to make your decision. ... Make your decision.
What is meant by choosing a first line of treatment in cancer therapy?
The first drug or combination of drugs a patient takes is called “first-line” treatment, which may be followed by “second-line” and “third-line” treatment. No specific treatment or combination of treatments works for every patient.
What are the treatments for cancer?
These options may include: Surgery. Radiation therapy. Chemotherapy. Hormone therapy. Targeted therapy. Immunotherapy. Active surveillance, also called watchful waiting.
What happens after cancer diagnosis?
After a cancer diagnosis, people with cancer and their families have to make a number of decisions about treatment. These decisions are complicated by feelings of anxiety, unfamiliar words, statistics, and a sense of urgency. But unless the situation is extremely urgent, take time to research your options, ask questions, ...
What is ASCO in cancer?
The American Society of Clinical Oncology (ASCO) and other cancer organizations publish guidelines and treatment decision-making tools. These tools help doctors and patients understand various treatment options. Learn more about treatment recommendations for the specific type of cancer that you have.
Is cancer care expensive?
The cost of cancer care is often high, and you may have expenses that you were not expecting. Your health care team can help you identify costs related to your treatment options or suggest ways to manage medical and related costs.
Can you get a second opinion from another oncologist?
Many people seek a second or even third opinion from another oncologist, and many doctors encourage it. Different oncologists may have different experiences with various treatments. So seeking multiple opinions can help you make a decision or confirm your current treatment plan. First check with your insurance company to find out if your policy covers a specific doctor or health care system.
Can cancer cause long term side effects?
Sometimes cancer can cause long-term side effects, or late effects, that might develop months or even years after treatment. Talk with your health care team about the possible long-term effects of each treatment option and how they are managed. In addition, discuss possible sexual or reproductive concerns with your health care team, including the risk of not being unable to have children. You have more options to keep your fertility if you address this concern before treatment, instead of waiting until after treatment.
How does cancer care team determine treatment options?
How your cancer care team determines your treatment options. Depending on the type of cancer, you might have a very limited number of treatment options, or you might have many. Your cancer care team uses established treatment guidelines to figure out what treatments should be offered to you. These treatment guidelines are based on research ...
What are the options for cancer patients?
There are other options to help someone with cancer, too, These include: Palliative care: Palliative care can help any person with a serious illness, such as cancer.
What is clinical trial?
A clinical trial is a research study that tests treatments on people. Sometimes these are new treatments that are being studied for the first time. Sometimes a clinical trial uses a treatment that’s already approved for a certain type of cancer and tests it on a different type of cancer.
What is the process of choosing the best treatment for your situation?
Choosing the best treatment for your situation is a decision that needs to be made after all information has been shared with you, and after you’ve had time to ask questions and have them answered. This process is called informed consent and allows people to play an active role in making decisions that affect their health.
What is shared decision making?
Shared decision-making is a process where decisions about your care are made with you, rather than someone making the decisions for you. Shared decision-making involves doctors and other members of the patient’s health care team working with you and your family or caregivers to make decisions together.
What tests are done to determine the stage of cancer?
The stage of the cancer. Other tests that might be done on the tumor to give more information about it (for example, biomarkers or hormone receptors) Other tests that might be needed to give more information (for example, blood tests, x-rays or other image tests, or genetic testing) Your overall health.
Why is shared decision making important?
But shared decision-making can help make sure you get the right tests and treatment, and that the right type of care is planned around them.
Making Treatment Decisions
Find out how your cancer care team determines treatment options and schedules, and what you should consider when making decisions about treatment.
Managing Your Treatment
Some people may manage parts of their cancer treatment at home. Learn about the special equipment you might need, and find out what you need to know about safely getting treatments at home. You'll also find resources to help you track side effects and medications.
Personal Health Manager
It can be hard to keep track of all the information that you get about your diagnosis and treatment. But keeping this information organized can help you feel less stressed and more prepared to talk with your doctor. The American Cancer Society Personal Health Manager can help.
How can open communication help in cancer care?
Open communication can help you and your doctors make decisions together and create a plan of care that meets your goals and wishes. If your doctor is not comfortable talking about end-of-life plans, you can talk to other specialists for help. (See the PDQ summary on Communication in Cancer Care .)
How can pain control help with cancer?
Pain and symptom control can be part of your care in any place of care, such as the hospital, home, and hospice.
What is CPR in cancer?
CPR is a procedure used to try to restart the heart and breathing when it stops. In advanced cancer, the heart, lungs, and other organs begin to fail and it's harder to restart them with CPR. Your doctor can help you understand how CPR works and talk with you about whether CPR is likely to work for you.
Why do doctors talk to patients about end of life?
Many patients who start talking with their doctors early about end-of-life issues report feeling better prepared. Better communication with your doctors may make it easier to deal with concerns about being older, living alone, relieving symptoms, spiritual well-being, and how your family will cope in the future.
What is clinical trial?
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
What is the purpose of supportive care?
Supportive care is given to prevent or treat, as early as possible, the symptoms of the cancer, side effects caused by treatments, and psychological, social, and spiritual problems related to the cancer or its treatment.
Why is supportive care important?
During active treatment to cure the cancer, supportive care helps you stay healthy and comfortable enough to continue receiving the cancer treatments. In the last stages of cancer, when a cure is no longer the goal, supportive care is used for side effects that continue.
What is the evidence that identifies deficits in the communication behaviors of oncologists treating patients who have advanced cancer
The evidence cited here strongly suggests that doctor-patient communication frequently does not fully support informed or shared decision making. This information will allow oncology clinicians to reflect on their communication habit s and consider modifying impedi ments to the timely planning for the transition to E OL care.
What is the end of life care for advanced cancer patients?
One interpretation of the evidence summarized in the section on Quality of End-of-Life Care in Patients With Advanced Cancer is that patients with advanced cancer too often receive burdensome and potentially harmful treatments without much chance of benefit and to the detriment of receiving purposeful end-of-life (EOL) care. Studies of patients with advanced cancer have identified factors that can influence EOL health care decisions and outcomes.
What is PDQ cancer?
This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about planning for end-of-life care in advanced cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions.
Why are regional variations in rates of utilization of health care resources near the EOL of interest?
Regional variations in rates of utilization of health care resources near the EOL are of interest because the differences are rarely associated with improved outcomes. While initial findings focused on differences between geographic regions of the United States, subsequent studies have demonstrated potentially meaningful differences between or within health systems. [ 10] A brief summary of some notable variations follows.
What percentage of patients in palliative care maintain or develop an accurate perception of prognosis?
Most patients in both arms maintained a belief that the goal of therapy was to “get rid of all my cancer.”. Nonetheless, 82.5% of patients in the palliative care arm maintained or developed an accurate perception of prognosis, compared with 59.6% in the standard care arm.
What is transition in cancer?
The word transition implies a passage from one place to another. Planning the transition to EOL care, therefore, requires a shared understanding of where the patient is in the advanced-cancer disease trajectory and why a transition is necessary or advisable.
What is phase model in cancer?
A phase model of planning the transition to end-of-life (EOL) care in advanced cancer. The trajectory of advanced cancer begins with the realization that disease-directed treatments are no longer curative.