When faced with deciding whether to continue cancer treatment, some patients or their loved ones may want to get a second opinion. Even when you place full trust in your doctor and cancer care team, you might wonder if another doctor could offer something else or more information. It's normal to think about talking to someone else, and your doctor should support you if you decide to get another opinion.
Remember that your cancer care team wants you to be sure about the decisions you make. You can read more in Seeking a Second Opinion. Clinical trials also might offer chances to try newer treatments that could be helpful. Your doctor can help estimate how likely it is the cancer will respond to treatment you might be considering.
For instance, the doctor might say that more treatment might have about a 1 in chance of working. The possible benefits, risks, side effects, costs, schedule of treatments and visits, and effect on quality of life should always be considered and discussed. When a person has tried many different treatments and the cancer is still growing, even newer treatments might no longer be helpful.
At some point you may need to consider that further treatment is not likely to improve your health or change your outcome or survival. Treatment in this situation is sometimes referred to as futile care.
Again, it's important to trust your cancer care team and discuss all options with your loved ones during this difficult time as you decide whether to continue treatment.
Whether or not you continue treatment, there are things you can do to help maintain or improve your quality of life. Be sure to ask about and get treatment for any symptoms you might have, such as nausea or pain. The decision to use radiation therapy depends on the type and stage of cancer, and other health problems a patient might have. Still, radiation therapy can be used to treat many types of cancer either alone or in combination with other treatments. While it's important to remember each cancer and each person is different, radiation is often the treatment of choice for the following purposes.
Some cancers are very sensitive to radiation. Radiation may be used by itself in these cases to make the cancer shrink or completely go away. In some cases, chemotherapy or other anti-cancer drugs may be given first. For other cancers, radiation may be used before surgery to shrink the tumor this is called pre-operative therapy or neoadjuvant therapy , or after surgery to help keep the cancer from coming back called adjuvant therapy.
For certain cancers that can be cured either by radiation or by surgery, radiation may be the preferred treatment. This is because radiation can cause less damage and the part of the body involved may be more likely to work the way it should after treatment. For some types of cancer, radiation and chemotherapy or other types of anti-cancer drugs might be used together. Certain drugs called radiosensitizers help radiation work better by making cancer cells more sensitive to radiation.
Research has shown that when anti-cancer drugs and radiation are given together for certain types of cancer, they can help each other work even better than if they were given alone. One drawback, though, is that side effects are often worse when they are given together. Cancer can spread from where it started to other body parts. In some cases, the area where the cancer most often spreads to may be treated with radiation to kill any cancer cells before they grow into tumors.
For instance, people with certain kinds of lung cancer may get radiation to the head, even when there is no cancer known to be there, because their type of lung cancer often spreads to the brain. This is done to help prevent cancer from spreading to the head even before it can.
Sometimes, radiation to prevent future cancer can be given at the same time that radiation is given to treat existing cancer, especially if the area the cancer might spread to is close to the tumor itself. Sometimes cancer has spread too much to be cured. But some of these tumors can still be treated to make them smaller so that the person can feel better.
Radiation might help relieve problems like pain, trouble swallowing or breathing, or bowel blockages that can be caused by advanced cancer. Even if you do not have severe anxiety or depression, it may be helpful to talk with a counselor or a cancer social worker. It can help you develop healthy ways to understand and respond to your needs and concerns. Considering a different treatment option If you need a second-line treatment, this does not mean that you did not get the right treatment the first time or that there are not more treatments to try.
Other factors that affect whether second-line therapy may work include: The stage of the cancer How well and how long the first-line treatment worked How long it has been since first-line treatment ended.
The side effects you had during first-line treatment Your age and general health Before second-line treatment starts, talk with your doctor about the goal of any suggested new treatments.
Talking with your health care team It is important to talk with your health care team about your care throughout the treatment process. Here are examples of the types of questions you may want to ask: What is the current status of the cancer? Are other treatment options available? Would you recommend starting a new treatment? Would you recommend participating in a clinical trial?
Should I consider not having a new type of treatment at this time? What will happen if I choose not to have another type of treatment? Who can help me understand what parts of my care are covered by my insurance?
If you and your doctor decide on second-line treatment, you may consider asking the following questions: How is this treatment different from the first-line treatment I had? What are the potential risks and benefits of the treatment? What are the possible side effects of this treatment, both in the short term and the long term?
What success rate does this second-line treatment have for my type of cancer? What is the expected timeline for my treatment plan?
Do I need to start treatment right away? What is the chance my cancer will come back after this treatment? How much experience do you have using this treatment for my type of cancer? Where can I find more information about the treatment you are recommending? Find more questions to ask the health care team. Considering a clinical trial At any point during your treatment, you may consider asking your doctor whether a clinical trial is an option.
Coping with a new treatment Learning your first-line treatment did not work can be scary. Some strategies include: Sharing your fears and anxieties with family, friends, clergy, or support groups , in-person or online Connecting with someone else who has had second-line treatment and understands the emotions you are experiencing Expressing your feelings in a journal or a blog Practicing stress management and relaxation techniques Spending time outside or around nature Listening to music Watching or listening to programs or shows that make you laugh You may continue to feel anxious or depressed or find it hard to focus or make decisions.
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