It’s normal to feel scared about making such an important decision, and it is a decision you need to make in partnership with your healthcare team. Women today are offered many more choices than in the past, and are often asked to make the final decision about their care. You need to gather information about your different treatment options so that you feel confident discussing your concerns with your doctors.

After talking with your doctors, keep in mind that you have obtained an expert medical opinion, and you need to understand your doctor’s perspective by asking why he or she has made that recommendation. It is important that you not compare yourself to other women in a similar situation. Even women who have the same diagnosis can have a different treatment plan—neither is right or wrong. Rather, it is individualized to you and your body. However, you can review with your doctor the information you learn from other women who have your type of cancer to better understand your own treatment plan.

In making a decision about what treatment to choose, make sure you identify what is most important to you. For example, if you are concerned about chemotherapy, what are the reasons for your concern? What questions do you need answered? Often, people fear that if they choose one type of treatment over another, they will always worry that they did not choose correctly. Instead, ask yourself questions such as: “What am I being told, and why? What do I think is the best choice for me at this time?” The most important thing is that you make the decision that you are most comfortable with.

For more guidance read our publications, Communicating With Your Health Care Team and Doctor, Can We Talk?

To learn more about your treatment options, contact The National Cancer Institute’s Cancer Information Service (1-800-4-CANCER), which provides the latest cancer treatment information as well as a list of comprehensive cancer centers.

The Lance Armstrong Foundation also offers helpful information.

CancerCare’s professional oncology social workers assist women with cancer by providing emotional and practical support, free of charge. Call 1-800-813-HOPE (4673) or email info@cancercare.org.

We have received several questions about treatment options, follow up and ongoing care. CancerCare is not a medical facility; rather, we are professional oncology social workers, so I will try and address your concerns generally. For any woman trying to make a decision as to what chemotherapy to be treated with, there are clinical practice guidelines established by the National Comprehensive Cancer Center (NCCN) to help physicians select the proper treatment in each individual’s case. There are also two tests available to women that can help them decide about treatment, and both tests provide information about the possible rate of recurrence of their breast cancer. The tests work with a specific type of breast cancer, estrogen receptor positive, and one such test, Oncotype DX, has been approved for payment by Medicare. Information regarding the other test is available at www.molecularprofiling.com but not does provide information whether they are approved for insurance payment. Before deciding on any treatment, make sure that your oncologist has a complete history of any additional medical problems and of any other incidences of cancer in the family. Lastly, if you have any uncertainties, seek out a second opinion.

After a diagnosis many women look for additional ways to prevent a recurrence and often explore complementary therapies as a way to help healing and promote their health. Activities such as yoga or mediation can provide a sense of peace and promote sleep and relaxation. There is little indication, however, that “natural” remedies such as vitamins or herbs have any effect on breast cancer. If you do decide to use herbal supplements, please be sure to let your doctor know since some can be harmful when combined with chemotherapy.

Learn more about CancerCare’s breast cancer services and resources.

Challenges that may affect older adults and their ability to make health care decisions include how they process information, how they cope with the stress of the diagnosis, and how their medical team communicates with them. With this in mind, family support can play an important part in your mother’s care. I’d start by asking your mother if she would like your help, and if so, what areas she would like help with. This might include meeting with her medical team to discuss her treatment plan or helping her prepare for her appointments.

Questions to ask about her treatment include:

• What is the recommended treatment and possible side effects?
• How could treatment affect other co-existing health issues?
• Is the goal longer survival, which may mean a more intensive treatment, or is it quality of life?

Ways to involve and organize your mother include:

• Take notes at her appointments or ask if you can record
• During the appointment, ask her if she has questions
• Repeat and review the information after the appointment, allowing her time to process information
• Keep a calendar to record her appointments
• Use a notebook to keep track of symptoms and side effects
• Create a file for all paperwork related to her diagnosis, including copies of important records
• Compile a current list of all her medications and phone numbers/addresses of all of her health care providers.

Your mother’s medical team is one of the most important aspects of her care, and as a health consumer she has every right to receive quality care. It is essential that older adults and their loved ones be able to openly and honestly discuss their care and any potential difficulties with their doctors may arise. For more guidance please read, “Doctor, Can We Talk? Tips for Communicating With Your Health Care Team”. If she is not comfortable with quality of care she is receiving, she may need to explore other options. Though this may seem daunting, your mother’s primary care doctor or even a local hospital can provide her with referrals.

Alternative treatment options for cancer can include a wide variety of approaches that are sometimes used in place of conventional measures of care practiced by Western practitioners, such as chemotherapy and radiation. Examples of alternative treatment options may include acupuncture, acupressure, homeopathy and naturopathy. When these alternative practices are used in conjunction with conventional medicine they are often referred to as complementary medicine. To learn more, read Memorial Sloan-Kettering’s publication, Complementary Therapies to Ease the Way During Cancer Treatment and Recovery .

When considering alternative and complementary treatment for cervical cancer, it is very important to communicate with your medical team. Some alternative therapies may be contraindicated for the treatment plan your doctor has recommended. The National Cancer Institute (NCI)’s Office of Cancer Complementary and Alternative Medicine and the National Center for Complementary and Alternative Medicine (NCCAM) provide extensive information and sponsor clinical trials that examine complementary practices in cancer care. For more information on these trials and the current research in this area, call NCI at 1-800-4-CANCER or read their publication, Thinking About Complementary and Alternative Medicine: A Guide for People With Cancer.

Making decisions on the best treatment plan for your cancer can be a daunting experience. An open discussion with your doctor can facilitate a plan of action that is mutually beneficial for your overall care. For tips on effective ways to speak to your medical team, see CancerCare’s fact sheet, “Doctor, Can We Talk?“ Tips for Communicating With Your Health Care Team.

Government institutions such as the National Cancer Institute (NCI) are reliable resources in locating information on cancer. NCI is the United States government’s agency for cancer research. It provides current information on cancer data, research programs and clinical trials on all types of cancers. You can contact NCI at 1-800-4-CANCER or www.cancer.gov. They provide a comprehensive booklet, What You Need To Know About Cancer of the Cervix.

Nonprofit organizations, like CancerCare and The National Cervical Cancer Coalition (NCCC), are also resources that can provide you with individualized assistance specific to your needs. By contacting these organizations, you may be connected with individuals that can provide you with support in the form of information, education, outreach and networking regarding cervical cancer.

Specifically:

• NCCC has an area on its website entitled, Health News, which outlines current cervical cancer information and research from the Center for Disease Control (CDC). You can also call NCCC at 1-800-685-5531.
• CancerCare’s publication, Your Guide to the Latest Cancer Research and Treatments: Cervical Cancer, reviews highlights from American Society of Clinical Oncology. You can learn more about additional services CancerCare offers those who’ve been diagnosed with cervical cancer (and their loved ones) in our cervical cancer website section.

Stage 4 non-small lung cancer is characterized by the spread (also known as metastasis) of lung cancer cells through the bloodstream to organs outside the lungs such as the liver, brain, adrenal glands or bones. These cells attach to the new areas and begin to grow new tumors. The cells of the new tumor site, however, are lung cancer cells rather than liver cancer cells. So the chemotherapy your sister’s oncologist has chosen to treat the main tumor site in the lungs would also be considered the most appropriate treatment for the lung cancer tumors that have grown in her liver.

One of the benefits of chemotherapy used for Stage 4 lung cancer is not only that it’s treating tumors known to exist, but it is also working on other tumors that may be too small to be detected yet. That’s why chemotherapy is considered a systemic therapy – it treats cancer tumors throughout the body.

Find more information about treatments for lung cancer in our booklet, Lung Cancer: Your Guide to the Latest Research and Treatments – Highlights from the 2010 Annual Meeting of the American Society of Clinical Oncology.

CancerCare also offers a full range of free support services for people affected by lung cancer.

Taking time to prepare yourself before your treatment can help reduce anxiety. One of the ways in which planning can be beneficial is by talking with your doctor about what to expect before and after a hysterectomy, both physically and emotionally. Our fact sheet, “Doctor Can We Talk? Tips for Communicating With Your Health Care Team, might be helpful as it provides tips on how to make the most out of your visit.

It is equally important to acknowledge you may have different feelings before and after your surgery. In order to explore those feelings, you may want to consider options for building in emotional support. Many women find comfort in support groups by sharing their feelings and learning how others cope with challenges and common fears. Indivudal counseling might also be helpful. You can learn more about CancerCare support groups or speak with an oncology social worker.

Other resources include:

• HysterSisters offers information, support, and resources for hysterectomy-related needs.

• Eyesontheprize.org provides FAQs answered by women who have been through a hysterectomy.

Additionally, some people find various activities help ease their anxiety such as journaling, meditating, exercise, and exploring nature. If there are activities in your life that bring you a sense of calm, it is particularly important during this time to seek out and engage in those activities.