Making decisions

How treatment decisions are made

Your cancer treatment team will discuss the treatment options for your cancer with you. Which treatment is recommended for you will depend on:
• the type of cancer you have
• how far your cancer has spread (the stage)
• other cancer treatments you may have had
• your general health
• if treatment is funded or not.
If you are offered a choice of treatments, including no treatment for now, you will need to weigh up the advantages and disadvantages. If only one type of treatment is recommended, you may want to ask your cancer treatment team to explain why other treatment choices have not been advised.
If you have blood cancer, 'watch and wait' may be a key part of treatment. While this waiting can feel difficult it is shown that you are no more at risk of your cancer getting worse than those receiving treatment. The decision to start treatment needs to be managed carefully as your blood cells and platelets are already weakened. A side-effect of treatment is to weaken them further. Your treatment team will monitor you very closely.
If you have a pre-existing health condition chemotherapy may not be right for you. Making decisions about treatment is not always easy. It is important to not be rushed into a decision – it needs to be the right one for you.
Ehara ngā whakataunga mō te whai maimoa i te mea māmā. He mea nui, kia kaua e tere rawa tō whakatau ko tēhea – ko te mea nui, ko te mea e tika ana mōu.
“At first I wondered if ignorance was bliss, but
after a week I thought, ‘No’. It’s my body and I
want to know what is going to happen, and I
want to know if I make a decision what will
happen. Silei ”
Mel 2045

Your cancer treatment team

You will see many health professionals during your treatment. These include oncologists, specialist cancer nurses, registrars and house surgeons (doctors). You may see a social worker, radiation specialists , or a dietician. If you have blood cancer you may see a haematologist.

Before you see your cancer treatment team, it may help to write down any questions you have. Taking notes during the session and bringing a family/whānau member or friend will be helpful. Some people like to record the discussion, but you would need to let the doctor know you wish to do this.
If there is something you do not understand, it is OK to say:
• would you please explain that again?
• I am not sure what you mean
• would you please draw a diagram, or write it down?
Your cancer treatment team will keep a close eye on you during your treatment. You may have blood tests and scans along the way to see how the treatment is working.

Talking with others

Once you have discussed treatment options with your doctor and family/whānau, you may want to talk them over with someone else. Talking it over can help you to decide what choice is right for you. 
You may be interested in Cancer Connect, run by the Cancer Society. This is a free telephone peer-support programme. Phone the Cancer Information Helpline 0800 CANCER (226 237) for more information on this programme.

A second opinion

At any time you may want to get a second opinion from another cancer specialist. You can ask your cancer treatment team or your GP to make a referral for you.

Taking part in a clinical trial

There are many new and emerging treatments for cancer. There may be clinical trials available that you could join.
Sometimes these trials give you access to better medications than would be available outside a study. Trials are also used to test the effectiveness and side-effects of medications that have not been widely used so that they may be used in the future. You should discuss this with your cancer treatment team.
Clinical trials are a vital part of the search to find better treatments for cancer, to test new and modified treatments, and to see if they are better than existing treatments.
In randomised clinical trials you will either receive the standard treatment currently available or the new treatment being tested.Many people all over the world have taken part in clinical trials that have improved cancer treatments, but not all medications tested in trials turn out to be helpful.
If you are asked to take part in a clinical trial, make sure that you fully understand the reasons for the trial and what it means for your treatment. The decision to take part in a clinical trial is yours.

Finding out more from your cancer treatment team

You may like to learn more from your cancer treatment team. Consider asking questions about:
• the possible advantages and disadvantages of chemotherapy,
• the side-effects you might experience
• the difference that waiting would make
• whether treatment would cure or simply control your cancer
• what would happen if you don’t have treatment
• how long your treatment might last and how often you will have to have it
• how your treatment will be given
• if you will need to stay in hospital
• how treatment might affect your day-to-day life now and in the
• how likely it is that the treatment will work for your situation
• if there is anything you need to be particularly careful about
during and/or after treatment.

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