Cancer Treatment: How To Decide Between Options
By Steven Vasilev MD
Making decisions when faced with options that you never heard of is difficult enough. When trying to do that while scared, confused and having been diagnosed with cancer is mind-boggling. How does one decide?
Consider using a tool based on something called Risk versus Benefit or Risk/Benefit Ratio. This simple approach may help you in making informed decisions. What it boils down to is asking yourself this question: How much benefit am I going to get for any decision I make compared to the risks from the treatment that I will agree to? You might find it helpful to use this tool to frame every single major treatment decision you make from this point on. Here s how you do it. Simply list all things you and your doctor can think of in one column called benefits , right next to another column called risks . Within these columns you might also put down what the chances are (usually expressed as a percent chance, or how many times out of a hundred) that a benefit or a risk might actually occur. Then compare the columns.
But what exactly are risks and benefits ? Everyone hopes and prays for a “cure” and that is the ultimate benefit the ultimate prize. But other benefits might be how fast one gets to a better quality of life or how long such a quality of life might persist for, or how fast you might be back on your feet after treatment. On the risk side there may be things like a possible colostomy (temporary or permanent), pain, infection, death from treatment, nerve damage etc. So, to take this logic a step further, if a doctor tells you that a cure is 90-100% with a given treatment but that you might risk a temporary colostomy, a moderate amount of permanent nerve damage and a week in the intensive care unit, it might be worth the trouble. If, on the other hand, the doctor tells you a cure is not possible but with the treatment option being proposed you might live 1 or 2 months longer, at the risk of a permanent colostomy, severe infection which might lead to death sooner, and a probable one month stay in the hospital, you might not be as anxious to undergo that treatment. There is a lot of ground in between these extremes regarding risk vs. benefit, but you get the idea. There is always a tradeoff and you should always consider what positive benefits you might get out of the pain and suffering that you might have to go through. You have to personally decide what you are willing to go through to get what benefit(s). What is important to you? This requires some careful quiet-time and introspection. No one can do this part for you.
Don t forget to take into account what risks and benefits are actually significant. In other words, are they only likely to happen 2% of the time or 50% or 75% or what? Is it rare or is it common? Some people won t want to accept even a 1% chance of colostomy, for example. Others will do whatever it takes, no matter what. It is important for YOU to decide what matters and what YOU will accept at every point in your treatment plan.
Whatever happens, it is important to look forward not back. You can t fix what has already happened, but you CAN influence the future. Choose wisely and don t look back.
Steven A.
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