When Cancer Strikes


The following article, written by Dr. James B. Dougherty, Jr., Deputy Physician-in-Chief, Clinical Affairs, Memorial Sloan-Kettering Cancer Center, is adapted from Newsweek magazine. The article appeared in a Health & Fitness supplement in Newsweek's October 28, 1996, issue.

Many people still think of a cancer diagnosis as an automatic death sentence. Today, we know this is not necessarily so. While cancer is an undeniably serious and in some cases a life-threatening disease, there is good reason for optimism. Within the past decade, cancer research has led to more effective treatments with fewer side effects. As a result, more than half of patients diagnosed with cancer today are successfully treated, and many others will lead long, productive lives well after their initial diagnosis.

The good news, however, should not diminish the solemn nature of the disease. Cancer is often treated aggressively, and newly diagnosed patients are typically faced with the prospect of making important decisions at a time when they feel deeply anxious and fearful. Some guidelines follow to help patients understand what lies ahead after a cancer diagnosis.

Consider a Second Opinion
Shock and disbelief are among the most common initial reactions to a cancer diagnosis. Seeking a second opinion is often useful for confirming a diagnosis and reassuring patients about its accuracy. It also gives patients an opportunity to verify a recommended treatment plan or explore another treatment option. Your primary care doctor can usually recommend an oncologist to consult for a second opinion. Also, regional cancer centers, or in some cases local hospitals, have physician referral services to put you in touch with cancer specialists. The National Cancer Institute also can refer you to cancer experts in your area.

Is My Doctor Qualified?
The above-mentioned resources also can help you determine if your physician is qualified to treat your particular condition. It also is reasonable for you to ask your doctor about his or her experience and qualifications, such as whether he or she is board-certified in a particular speciality. In addition, an important component of good cancer care is establishing rapport and trust between physician and patient. Patients and their doctors must be able to work together to treat the cancer most effectively. And as a patient, you should understand the goals of the treatment plan you and your doctor agree upon. The plan should include a time line that lets you know how long the therapy is expected to last and when you and the doctor will determine if the treatment is effective.

A Multidisciplinary Treatment Approach
Cancer is an incredibly broad term that encompasses more than 100 different diseases. Tumors can develop in almost every tissue in the body, and rarely are two alike. This means that patients with the same type of cancer may receive different treatments. Cancer therapies often are tailored to a patient's age and medical history, as well as the particular tumor type and stage. In many cases, this will involve a multidisciplinary approach provided by a team of physicians that may include a medical oncologist, radiation therapist, or surgeon. This helps to ensure that you are being cared for by doctors who have broad experience in treating cancer.

Getting Answers to Your Questions
The questions and concerns you have about your condition and treatment are important, and your physician should make time to give you answers. However, physicians often wait for clues from their patients to determine how much to say. You should let your doctor know if you want more information. Also, it is often helpful to have a friend or family member accompany you when you discuss various treatment options with your doctor. A companion can provide an extra pair of "ears" or ask questions you might not think of.

What Does Cancer Treatment Involve?
It is a misconception that most cancer treatments involve extended hospital stays or are extremely debilitating and painful. Many cancer therapies, including chemotherapy, are now administered on an outpatient basis, which often allows patients to resume normal daily living more quickly. Some side effects -- namely nausea, hair loss, and tiredness -- are still common, but they are often temporary. Today, quality of life is extremely important in cancer care. New therapies now enable many patients to lead relatively normal lives, including keeping regular work and exercise schedules.

The Emotional Side
Studies suggest that patients who are fully informed about their disease and treatment options tend to have better outcomes and fewer side effects than those who simply follow doctors' orders. Being informed appears to drive a positive psychological outlook that enables patients to feel like they have some degree of control over the course of their disease. However, the emotional impact of living with cancer can be overwhelming. Feeling anxious is normal, but if your anxiety leads to prolonged insomnia, loss of appetite, a lack of interest in your normal activities, or a preoccupation with death, it is time to consider outside support. Cancer support groups may be accessible through the hospital where you are receiving treatment or in your community.You may also consider individual or family counseling or turn to a minister or rabbi for spiritual support.