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Long-Term Cancer Impact - Treatment Decisions
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By Alex Cukan
UPI Health Correspondent
ALBANY, N.Y., Jan. 23 (UPI) — A cancer diagnosis can be overwhelming. Not only must the patient decide how to treat the disease, he or she must also consider the treatment's long-term side effects.
A report by the University of Texas M.D. Anderson Cancer Center, "Living With and Beyond Cancer," says that for many years, as doctors concentrated on treating the cancer as effectively as possible, a patient's quality of life often was the last thing considered.
This is not news to cancer patients or their caregivers, but it is good to hear that medical science is beginning to recognize that the rest of a cancer survivor's life is also important. More than 10 million U.S. cancer survivors – many of them very vocal – are also examining how to maintain lifelong good health.
The report details the main types of health problems – including heart, arthritis/osteoporosis, cataracts, thyroid, lung, hearing loss, memory loss and circulation – associated with cancer affecting different organs.
"When a person is diagnosed with cancer, they are plunged in crisis action mode. The diagnosis is a shock, the whole thing is overwhelming, but they are forced to act and put aside their grief reactions – and they have to decide which doctor, which hospital, what procedure, if their insurance will cover it and who will pick up the slack of their life and responsibilities while they are being treated," Dr. Larry Lachman, a licensed clinical psychologist at Chapman University-Monterey, Calif., told UPI's Caregiving.
"During this time they are forced to make medical student/doctor decisions without training."
Lachman, who is a cancer survivor himself, treats cancer survivors and leads cancer support groups. He was diagnosed with prostate cancer at age 39, 10 years ago.
"When facing cancer treatment decisions, patients should at the very least get a second opinion and get treatment recommendations from more than one source," Lachman said. "Look at a reference book of expert doctors – doctors who specialize in the cancer treatment option chosen and who do a high volume of the treatment."
Someone facing a cancer treatment decision experiences tension as the result of having to choose between undesirable options, according to Lachman. The person must choose between "the lesser of two evils" – such as "Do I choose radiation therapy?" or, "Do I do hormone therapy?" according to Lachman.
"To help in the decision-making process, I suggest patients list all treatment options they are considering and underneath list all the pros and cons, and then they should rank them in order from 1 to 5 with five being the most important."
In his own case, Lachman said he got a recommendation of specialists from three different people, which helped him narrow the decision.
"I also chose to be treated where it would be convenient to friends and family so I could have their support, so I looked for someone located within an hour of where I lived," Lachman said.
Lachman said that once treatment ends or there's a break, emotionally "everything comes tumbling down – sometimes called the emotional abyss – when the patient deals with the loss that cancer brings: the loss of a body part, the loss of stamina, the loss of health, the loss of the role at home, the potential loss of work, the potential loss of appearance and the potential loss of sex and intimacy."
"Cancer patients need support from family, friends and a support group to deal with these losses and help them reconstruct their life into a 'new normal,'" said Lachman. "I can't be exactly the same person I was before, but the cancer patient needs to ask, 'How can I be a new me and go after life pursuits?' – 'How do I reconstruct a new normal?'"
Many people with cancer adapt emotionally and have a better appreciation of life – they don't want to waste time, because they now have a real appreciation of their mortality, according to Lachman.
"Many long-term cancer survivors also find that either the disease or the treatment ages them in some areas – some can no longer have kids, some lose sexual functioning, some have memory problems and many automatically end up being a smart hypochondriac. Once you have cancer you can't assume a headache or a backache is nothing – it could be something coming back or it could be a second cancer, because once you have cancer you have a better chance of getting a second cancer," Lachman said.
"We don't know why bad things happen to good people – but no matter what, we can influence the ride."
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Alex Cukan is an award-winning journalist, but she always has considered caregiving her real work. UPI welcomes comments and questions about this column. E-mail: consumerhealth@upi.com
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