Dr. Daniel - The Cancer Directory

However, especially when first diagnosed, you may feel unsure if it will be detrimental for you not to start treatment immediately. It would be worthwhile checking how much time you can take safely with your own doctor or an integrated medicine consultant (see the Resources Directory pages 351–3).

Explain that you wish to consider all the options available and ask them the following questions:

• How aggressive is my tumour and how fast is it growing?

• How long would you estimate my cancer has been there?

• Do you feel it would be detrimental to postpone action for a few weeks while I look at all the options? (If the answer is yes, ask why. What do they think will happen to your cancer during the delay?)

If you are considering treatments that are beyond your doctor’s field of expertise, such as immunotherapy or intravenous metabolic treatment, you may find that some doctors will not consider them a worthy alternative, and will try to influence you into looking only at more conventional treatments. You need to be sure that you are getting a balanced and reasoned opinion. Sadly, it is not unusual for a doctor to write off a treatment approach while having absolutely no knowledge of what it’s about. Conversely, some alternative doctors may be overly dismissive of the value of conventional medical treatment. In this case, arrange to speak to an integrated medicine doctor who is genuinely committed to getting you the very best of both worlds – orthodox and alternative.

While your doctor may be happy to discuss various orthodox treatments, a frequently different reaction may appear when you bring up the subject of integrating alternative treatments with what he has to offer.

Ideally, your doctor will be receptive and open to what you want to consider. If he has no knowledge of a particular treatment or approach, he should welcome any information you can supply him and study it. He can then consider whether there are any contraindications to using it alongside orthodox treatments, and he can engage in an informed discussion with you about formulating a treatment plan which best meets all of your needs.

However, this scenario is not typical of what happens to the majority of people who try to discuss integrating their cancer treatments with their doctors. You may encounter a number of reactions, ranging from dismissal to an outright declaration that what you are considering is rubbish and a waste of money. So, you need to be prepared with the right attitude to achieve the best possible working relationship on this matter.

Attend the appointment armed with as much information and research evidence about the treatments you are considering as possible. If your doctor dismisses the treatments out of hand, ask him:

• How much does he actually know about the treatment?

• On what evidence is he basing his opinion?

If your doctor has little knowledge of the treatment, offer him the information so that he can give you an informed opinion. If he offers you a sound reason why he considers your proposed treatments unsuitable for you, or has reason to doubt the reliability of the treatment or practitioner, that may be information you need to know. If, however, your doctor displays pure prejudice, then you have to consider whether this particular doctor is going to be the best person for you to work with.

The words ‘working with’ are key here. If you feel you are unlikely to develop a partnership with your doctor without feeling compromised, then you might want to think about changing to a team that will better fit your needs. Though this may seem drastic and difficult to consider when feeling under pressure, bear in mind how important it is that, in the long term, you are involved in your own decision-making process, that your opinion is listened to and that you are ‘choosing your treatment’, not being ‘given it’.

In summary, when diagnosed with cancer and evaluating treatment options:

• Get the facts about your illness

• Make a list of questions you want answered (see Chapter 3)

• Ask to see the consultant (rather than the juniors) responsible for your care

• Do not be afraid to ask anything, but let your team know how much you want to know

• Insist on being told the truth

• Make sure you know what alternative and complementary approaches are available

• Take a relative or close friend with you to make notes (or take a cassette recorder, although this might be intimidating for medical staff and often means that their answers will be far more guarded)

• Discuss any queries with your GP

• If you are not happy about any aspect of your care, tell your doctors or the cancer services manager of the unit where you are being treated

• Talk to nurses, radiographers and pharmacists, who are often useful sources of information and have more time to explain things that you may not have understood in the short time spent with the doctor

• If you are unsure about what to do, ask to see the consultant again or seek a second or third opinion

• Take steps to prepare and support yourself and your immune system throughout your treatment programme (see Chapter 7).

The main treatments used currently for cancer are:

• surgery

• radiotherapy

• chemotherapy

• hormone therapy.

Often, the first step in cancer treatment is surgery. The aim of cancer surgery is to remove the whole tumour, leaving behind as much of the normal tissue as possible. The tumour must be removed in its entirety for the operation to be a success and the pathology department must find that there are clear margins of healthy tissue around the entire tumour. If not, then further surgery will usually be recommended.

You may have heard that operating on a tumour can encourage it to spread. That is a consideration your surgeon will take into account, and great care will be taken to minimize the risk of spread during surgery. If your surgeon thinks this might have occurred, he may well recommend that you have follow-up systemic treatment, such as chemotherapy, to take care of it.

Both orthodox and integrated cancer doctors agree that the risk of cancer spreading during surgery is far outweighed by the risk of leaving the tumour to continue to grow, metastasize and cause further problems. New evidence also shows that existing tumours secrete proteins that can facilitate secondary growth in other organs. So, the removal of all possible cancer from the body is vital.

Success with cancer surgery comes from knowing exactly how much tissue needs to be removed, so an accurate assessment of tumour size and shape is essential before deciding on the type of operation for your particular type of cancer.

• Find out what sort of operation is being proposed.

• Establish how experienced and skilled at this type of surgery your surgeon is.

• Find out if there are any new developments in surgery for that operation.

• Find out how long you will need to be in hospital and need to take off work afterwards.

• If you are having surgery done privately, make sure you know all the costs involved.

• If you have health insurance, make sure in advance that all the fees will be covered.