After Diagnosis: A Guide for Patients and Families

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Making treatment decisions

The number and kinds of treatment choices you have will depend on the type of cancer; the stage (extent) of the cancer; and your age, overall health, and personal needs. You are a key part of your cancer care team – you should talk about what treatment choices are best for you. Don’t be afraid to ask questions – as many as you need. Make sure you understand your options. A cancer diagnosis almost always makes people feel like they have to start treatment as soon as possible. But you usually have plenty of time to think through all your options so you can make the best possible choice.

How is cancer treated?

The major types of treatment for cancer are surgery, radiation, and chemotherapy (which are reviewed in the next section, “Common types of cancer treatment”). You might also have heard about hormone therapies, biologic therapies, targeted therapies, and stem cell transplants.

We have detailed information on all of these treatments that may help you as you make decisions. We also have more details on common treatment side effects and how to manage them. Call 1-800-227-2345 to learn more and have free information sent to you, or learn more at www.cancer.org.

What treatment will be best for me?

Your cancer treatment will be based on your situation. Certain types of cancer respond better to certain types of treatment, so knowing the exact type of cancer you have is an important step in deciding which treatments will work the best. The cancer’s stage (how much cancer there is and where it is) will affect treatment options, too.

Your health, lifestyle, and personal preferences will also play a part in deciding which treatment plan is best for you. Some types of treatment might work better for you than others, so be sure you understand your options. Don’t be afraid to ask questions. It’s your right to know what treatments are most likely to help and what their side effects may be.

What is the goal of my treatment?

Before starting treatment, ask about the goal of treatment. Is the purpose of the treatment to cure the cancer, control it, or treat problems it’s causing? This is a key part of the decision-making process. Sometimes the goal of treatment can change over time.

What is remission?

Remission (re-mish-un) is a period of time when the cancer is responding to treatment or is under control. Some people think that remission means the cancer has been cured, but that is not always the case.

In a complete remission, all the signs and symptoms of the disease go away and cancer cells can’t be found with any of the tests used for that cancer. It’s also possible to have a partial remission. This is when the cancer shrinks but does not go away completely.

Remissions can last anywhere from many weeks to many years. Complete remissions may go on for years and over time be considered cures. If the cancer returns, more treatment might lead to another remission. A cancer that has recurred (come back) may respond to a different type of treatment, such as a different group of drugs or radiation versus surgery.

What is staging?

Staging is the process of finding out how much cancer there is and how far it has spread. Staging the cancer is a key step in learning your treatment choices. It will also give your health care team a better idea of your overall outlook for recovery. But the tests and exams needed to stage a cancer can take time, and people are often eager to begin treatment right away. Try not to worry that the staging process is taking up treatment time. Keep in mind that by staging the cancer, you and your health care team will know which treatments are likely to work best before starting treatment.

A staging system is a way for your health care team to sum up the extent of the cancer. The TNM system is the one used most often. It gives 3 key pieces of information:

  • T usually describes the size of the main tumor and whether it has spread to nearby tissues and organs.
  • N describes how far the cancer has spread to nearby lymph nodes.
  • M shows whether the cancer has spread (metastasized) to other parts of the body.

Letters or numbers after the T, N, and M give more details about each of these factors. For instance, a tumor staged as T1, N0, M0 is a tumor that is very small, has not spread to the lymph nodes, and has not spread to distant parts of the body.

Once the TNM descriptions have been found, they are grouped together into a simpler set of stages, in most cancers stage 0 through stage IV (0-4). As a rule, the lower the number, the less the cancer has spread. A stage IV (4) means a more serious, widespread cancer.

After looking at your test results, your doctor will tell you the stage of your cancer. Be sure to ask your doctor any questions you have about what the stage of your cancer means and how it affects your treatment options.


Last Medical Review: 03/06/2014
Last Revised: 04/07/2014