Understand Your Conventional Treatment Options

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 In addition to the information you generate from your own research, you should expect your oncologist to carefully explain which types of conventional treatment are recommended for your type and stage of cancer. The options will typically fall into one or a combination of three primary treatment modalities:

·         Surgery: removal of the tumor by operating on it

·         Radiation: exposure to x-rays or radium

·         Chemotherapy: the use of cytotoxic chemicals

Surgery is the most frequently employed cancer treatment. It is best used when the cancer is small and has not moved to other parts of the body. Radiation therapy is employed in approximately one-half of all cancer cases. It is often used in combination with other treatment options, for example either before or after surgery. Chemotherapy is most often used when the cancer has spread or when the diagnosis is a systemic-type cancer. It is often used in combination with radiation therapy and surgery to control tumor growth.

Three other types of conventional medical treatment modalities are:

·         Hormonal: employs or manipulates bodily hormones

·         Immunotherapy: enhancing the body's own immune function

·         Investigative: experimental programs

Hormonal treatment is used in cancers that depend on hormones for their growth. Hormones are either removed, added, or their production is blocked through drugs or surgery that re-moves the hormone-producing gland. Immunotherapies include the cytokines like the family of interleukins and interferons, and are an attempt to boost or restore the body's natural defense system. Many people believe immunotherapies will soon comprise a fourth widely accepted treatment modality. At this writing, their scientific efficacy is yet to be established. Investigative protocols are experimental. They are typically the last choice.

As you evaluate your conventional treatment options, I ask you to consider some of my personal observations from a decade and a half of helping patients make informed choices:

1. While surgery is the most common form of conventional treatment, dozens of types of cancer diagnosis do not indicate surgery. Many patients panic when they are told their cancer is "inoperable." If you have been told that your cancer is inoperable, do not despair. Recognize that inoperable does not equate with incurable!

2. If your oncologist suggests surgery, and you concur, the decision as to who actually performs the procedure is yours. Your choice of surgeons is important. You're more likely to get a well- qualified surgeon if you choose one who is a fellow of the American College of Surgeons and who is also board-certified in his or her field. Only about half of practicing surgeons are board- certified, so be sure to ask.

Special note to premenopausal breast cancer patients:

You typically have some flexibility on the timing of your surgery. Scientific evidence is mounting that fewer breast cancer recurrences are reported among women who choose to have their surgery during the luteal phase of the menstrual cycle, i.e., 14-30 days following the onset of menstruation. Except for one Canadian study which suggested Day 8 to be the optimal time, research shows surgery performed in the latter half of the menstrual cycle results in the fewest recurrences. Ask your surgeon for the most up-to-date research information prior to scheduling. You may have to assert yourself here; most surgeries are scheduled at the convenience of the surgeon and/or the hospital.

3. Thoroughly understand chemotherapy. Before you say yes to chemotherapy, ask to see proof, such as scientific papers and reports, on the effectiveness of the treatment being offered. Examine the hard evidence that the suggested chemotherapy protocol actually cures, extends life, or improves quality of life. Those are the three "outcomes" against which you must measure all treatments—conventional, experimental, complementary, and alternative.

If your clinician uses the terms "response" or "tumor response" or "reduce the tumor burden," these represent different standards. These terms mean shrinkage and a corresponding reduction in the immune-suppressive effect the tumor has. None of these terms are synonymous with a cure, which actually requires that your body fight the cancer on a cellular level and that your immune system maintain a disease-free state. To maximize your opportunity for such a response, I encourage you to follow as many of the health-enhancing, life-enriching principles in this book as possible.

Study the chemotherapy treatment option in depth. Do your own research. Ask about both short-term and long-term side effects. Request the names and phone numbers of long-term survivors who were treated with similar regimens. Ask, for their experience and analysis. Know exactly what you can expect— and not expect—this treatment option to accomplish. Once you possess that information you are in a position to make a truly informed decision.

4. The administration 'of chemotherapy is not an exact science. Ask your oncologist about chemotherapy sensitivity (in vitro) testing. Here, samples of your tissue are chemically analyzed in laboratory tests to determine interaction with different agents. In about a week, your oncologist will receive a report establishing which drugs are not likely to work as well as the most active agents. The net effect is a personalized treatment program optimized before you begin. Do not panic if there are changes in the treatment program. It is common to try different chemotherapy drugs as well as different combinations. These changes are the oncologist's attempt to improve the effectiveness of the treatment.

5. Chemotherapy may be in pill form, and be taken by mouth, or it may be in liquid farm and injected into a muscle or, most commonly, given through a vein. The drugs may be administered in a daily, weekly, or monthly program for periods ranging from a few months to a lifetime in a few cases. Side effects, once the fear of all patients, are nPlw being more effectively controlled and vary widely from individual to individual. Refer in this book to #36, "Minimize Treatment Side Effects," for helpful things you can do to control uncomfortable side effects.

6. Radiation therapy is most often administered by means of an external beam machine, though internal radiation is becoming more common. Here, radioactive material is surgically implanted into or on the area to be treated. This procedure requires precision. You will maximize our opportunity for receiving excellent care if you choose a physician who is certified by the American Board of Radiology. Ask.

All cancers are treatable. Even in cases where the cancer is advanced, experimental investigative programs are available. If your cancer is not responding to conventional treatment, ask about hormonal treatment and biological response modifiers. Especially consider the many complementary and alternative programs described in this book. You are entitled to understand the full range of treatments available. From that understanding, you will have the knowledge and power to make the most intelligent treatment decisions.

Once again, conventional treatment has its important place. In interviews with thousands of cancer survivors, over 96 percent stated they initiated a course of conventional therapy. It is a myth that cancer survivors turn exclusively to alternative, nontraditional cancer treatments in large numbers. In the late 1980s, a Food and Drug Administration study estimated that 40 percent of cancer patients use unconventional treatments. That may be true; in fact, I believe the number may now be much higher, perhaps 60 percent. But survivors do not give up the traditional treatments. They integrate complementary and alternative practices into a comprehensive recovery program. That is what the guidance in this book is all about.

A final thought on conventional treatment options:

Please clearly understand this point: The vast majority of survivors select a conventional program using surgery, chemotherapy, or radiation, often in combination, as the foundation of their treatment. Survivors then supplement this conventional approach with many of the ideas presented in this book. I recommend you implement a conventional medical treatment program based on your own research and your own strong belief. However, I also believe your treatment is not complete until you initiate a comprehensive and integrated recovery program. Given our current levels of understanding, this integration represents your very best opportunity for surviving cancer.

An Important Thing You Can Do

Ask your oncologist to explain the specific treatment options available to you in the areas of surgery, radiation, and chemotherapy. Ask also about hormonal, immunotherapy, and investigative programs. Ask for his or her recommendation. Record this information in your Wellness and Recovery Journal. Do not give your approval for treatment just yet. First, more work remains to be completed.