Dr. Daniel - The Cancer Directory

Generally speaking, the aim of cancer doctors is to attempt to remove the primary tumour before it has spread, then to destroy any stray cells around the site of the primary with radiotherapy, or more distantly spread cells with chemotherapy. With blood cancers, attempts are made to destroy the cancer cells in the blood with chemotherapy and then to remove the abnormal parent cancer cells from the bone marrow, replacing them with healthy cells. This involves bone marrow grafts, which use healthy new marrow from a donor after the patient’s unhealthy bone marrow is destroyed.

Nowadays, cancer treatments tend to be more aggressive, offering the whole gamut of surgery, radiotherapy and chemotherapy right from the start of the treatment process. In the 1970s and 1980s, it was more usual to treat the primary tumour only, saving radio-and chemotherapy for recurrences. However, the thinking these days is that it is better to go for complete eradication or cure from the outset rather than allowing the cancer to become established in the body.

Because doctors want to ‘nip cancer in the bud’ as soon as it has been diagnosed, there is often an enormous sense of rush and panic at the time of diagnosis. And being on the receiving end of this can be traumatic. While you are still reeling from the news and going through an emotional reaction, those around you are busy trying to get on with starting your treatment. So again, it should be stressed how important it is that you slow them down until you have made the right choice for you and are ready to undergo your well-considered treatment.

On occasions, you may be advised to have chemotherapy first to shrink and contain the primary tumour before attempting to remove it surgically. Sometimes, the primary or secondary tumours may be deemed inoperable – in which case, the treatment offered is usually chemotherapy. If the tumour is widespread throughout the body, the treatment given may be palliative – intended to deal with the symptoms rather than cure the disease. This usually amounts to shrinking the tumour with radio-or chemotherapy to buy vital time for you to get your own integrated health creation programme together.

When thinking about treatment, the following are the questions you need to ask:

• What treatments are suggested for my cancer and why?

• What are the chances of the tumour being cured?

• What are the side-effects of treatment in the short and long term?

• What are the risks of treatment?

• Do I trust my cancer consultant or do I need to seek a second opinion?

• Is my hospital able to give me access to the most up-to-date treatment for my type of cancer, or should I be looking further afield?

• Which are the centres of excellence for my particular kind of cancer nationally and internationally?

• Are there treatment research trials going on for my kind of cancer and, if so, would I like to be entered into one of those trials?

• Do I want to go straight into medical treatment of my cancer or do I need time to prepare myself mentally, physically and practically first?

• If the results with conventional medical treatment are not likely to be good, do I want to keep medical treatment on hold as an option while I work entirely on improving my health with alternative cancer treatments and holistic health promotion?

• If I wish to defer treatment while trying to work with natural methods, am I sure that I am not putting myself at undue risk in doing so?

• You may also wish to ask: If the tumour cannot be cured, what is the likely progression of the disease and my life expectancy?

There are four different types of specialists who look after people with cancer:

• surgeons, who are usually the first to be consulted if there are primary or secondary tumours that are removable (but who are not necessarily cancer specialists)

• medical oncologists, who specialize in the treatment of cancer with chemotherapy and/or radiotherapy

• palliative care physicians, whose role is to help manage your symptoms, and arrange for your support and care

• anaesthetists, who can offer specialist help if there is a problem with severe, ongoing pain.

It varies from place to place whether you see an oncologist or surgeon first, but it is wise to make sure you do see an oncologist at some point because they are specialists in cancer and its treatment. Ask your GP whether there are any other relevant specialists who may be able to help you.

When your specialists tell you about your treatment options, it is important to establish the details of the proposed treatment so that you can make an informed decision.

As you focus on a particular treatment as the most likely one for you, make sure to ask the following questions:

• What will the treatment involve?

• When and where will it take place?

• Who will be responsible for my treatment?

• How long will it continue for?

• How will it make me feel?

• How long should I take off work for treatment and convalescence afterwards?

• What side-effects can it cause?

• How long will it take me to get over these side-effects?

• Will these side-effects be permanent or temporary?

• What are the benefits of the treatment in terms of prolonged survival, symptom improvement or disease-free interval (the time you can expect to enjoy with no problems from the cancer)?

• Are there any extra ( adjuvant) treatments that might further improve my well-being or chances of survival while having this treatment?

• Does the doctor see any problem with my taking vitamin/mineral supplements alongside the treatment (making sure his or her opinion is a well-informed one)?

• Does the doctor know of any promising ‘medical frontier’ treatments or trials that might offer a better chance of prolonged survival than the treatment I am being offered and, if so, where are these treatments available and at what cost?

Once you are in possession of this information, you will be able to decide whether the side-effects (temporary and permanent) of the treatment outweigh the possible benefits you may receive in terms of symptom improvement and life expectation.

You may find this in-depth questioning of your doctors too difficult to go through. Some people do not want to know exactly where cancer is in their bodies if it is not causing problems nor do they want to pin their doctors down to telling them the exact facts about the effectiveness of the treatments being offered, as this may inhibit their being able to put 100 per cent of their faith in the treatment.

However, I would strongly recommend that, at the very least, you get a clear diagnosis of the primary tumour so that you are certain that you do have cancer, and get some indication of how serious your situation may be. In this way, you can make an informed decision about whether to go ahead with conventional treatment or not with an assessment of the risks involved if you do not feel able to undergo medical treatment.

Next, think about the timing of your treatment. Ask yourself:

• Do I want to go straight into medical treatment for my cancer, or do I need a little time to prepare myself mentally, physically and practically first?

Take the time you need to get yourself in the right frame of mind for treatment. Preparing properly for treatment is covered in detail in Chapter 7.

Before you commit to a particular treatment, be sure you understand both the benefits and side-effects that you may experience.