Читать книгу Cancer is a Word, Not a Sentence - Miriam Stoppard - Страница 24

The whole approach to treatment of any cancer is balancing the potential benefits of a treatment approach against the potential risks—both the consequences and/or the side effects of the treatment, and the risks associated with not receiving that treatment.

To make it easier to conceptualise this balancing process, we can use the following checklist of important questions, the ones at the centre of the whole approach to the treatment of your particular cancer.

Those questions are:

First, what is this particular cancer likely to do in the future in my case? In many respects, this is the most important question of all in trying to get a grip on your particular situation and what treatment options are appropriate.

What you really want to do is get an idea of what your cancer is like in respect to the following three aspects:

1 Might the cancer recur? Is the chance of it coming back high, or low, or intermediate?

2 Might it spread? Might the cancer metastasise to other parts of the body (for example, the bones or the lungs). And if that is a possibility, is the chance of it happening high, or low, or intermediate?

3 Might it pose a risk to my health or my life? If it does, is the size of that threat big, or small, or intermediate? And in what time frame might it do damage: short-term, long-term, or intermediate?

Second, what are the treatment options, and which ones may make the future better for me? The aim here is to get a handle on the different treatment options, answering the question, ‘What could we do?’ before the question, ‘What will we do?’ The seven-category system, which follows shortly, will help you with this. And in Part Two we will discuss the various types of treatment in greater detail.

Third, what are the risks, the consequences, and/or the side effects of those treatment options? The aim here is to find out how the proposed treatment option is likely to affect the quality of your life, then for how long.

As you get the basic facts from your medical team, and more information from the pharmacy, and the out-patient treatment unit staff, among others, keep in mind these things:

Some treatment side effects vary. Some side effects are definite and universal: if you have a chemo drug called Adriamycin, for example, you will definitely lose your hair, and it will definitely grow back. But with many treatments—radiotherapy is a good example—you may have a lot of skin reaction or you may have none at all. You can predict the amount of skin reaction to a certain extent by how easily you burn when you sit in the sun. But even so the effect may vary.

Which means that you have to ask yourself this question: How much would a particular side effect alter my quality of life?

This is a very personal matter. You have to think about what you do in your daily life and what you enjoy. Then you have to assess the way it would affect you, and how much that would matter to you. The best way to do this is to think about the worst-case scenario: if you got the side effect, what’s the worst it could do to your quality of life? Then think of that continuing over the estimated length of time (which is of course just that, an estimate). That will give you some idea of the worst risk from the treatment. And that will make it a bit easier to balance the side effect against the potential benefit.

Let’s keep all that in mind as we look at the objectives—the planned benefits—of the treatment plan.