Thursday, November 12, 2015

A better way to make decisions about your cancer treatment

Very glad to hear that shared decision-making is gaining traction. This is the way I prefer to work with my oncologist. Here's an overview from the American Cancer Society http://www.cancer.org/treatment/findingandpayingfortreatment/understandingfinancialandlegalmatters/informedconsent/informed-consent-shared-decision-making
Shared decision-making is a newer way of talking about treatment and treatment decisions, and some doctors are using it. It works like this: the doctor gives the patient information about the pros and cons of all the treatment options, including no treatment. This often means “homework” for the patient, such as reading, looking at DVDs, or sifting through other types of information. The patient tells the doctor about factors (preferences, health problems, home conditions, and such) that might make each treatment option better or worse than the others. Together, the patient and doctor decide which treatment is best for the patient. Or they may decide on something else, such as waiting for further developments before choosing a treatment. 
This is quite different from just saying “yes” or “no” to the treatment the doctor offers you. It may mean that you must take in more information, ask more questions, share more about yourself, and take more time to sort through your options together.This type of decision-making is especially helpful when there is no single “best” treatment option. For many people, the extra effort is worth it – they feel more certain that they made the best treatment choice for themselves. But for others, it may be too much or feel overwhelming (see the next section called “What if I want my doctor to make the decisions about my care…?). 
It’s OK to tell the doctor that you don’t want to share decision-making. But if you do want this kind of input let your doctor know. Be sure that you understand all the reasonable options for your situation, and go over them with your doctor. See the section called “What questions should I ask during informed consent?” to get some ideas of what to ask about each treatment option. Keep in mind that your doctor may not have as much information about some treatments as others, and you may need to get a second opinion to get a more complete picture.

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