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The Urgency of Cancer Treatment: Why the Rush?

Why the mad-dash rush? By the time a malignancy becomes a detectable tumor, it has been lurking for some time—sometimes several years.

Few cancer diagnoses require immediate treatment. By immediate I mean within days or even weeks. Smart, measured choices eclipse quick decisions informed by limited information—or by oncologists lacking specific expertise for the malignancy you may be hosting.

The most challenging diagnoses—think glioblastoma multiforme or pancreatic cancer as examples—require fairly immediate treatment. However, even these types typically do not have to be treated in a week or two.

Complications from cancer, such as a tumor pressing against a major organ or against nerves, causing numbness—or an enlarged spleen so ginormous it may imminently rupture… these are urgent situations requiring quick intervention.

I put off the removal of my seven pound spleen (containing five pounds of leukemia cells) for two entire months before deciding on the surgeon and scheduling the operation. Candidly, looking back almost three decades, I do not recall getting rushed to move any faster than the pace I set.

The urgency to treat is often driven by fear—fear upon hearing the words ‘you have cancer’. And the fear, anxiety, and urgency instilled by those around you: family, friends… and, alas, the urgency instilled by the oncology professionals with which you initially engage.

After the initial shock, most people want to deal with the diagnosis head-on; get it in the rearview as soon as possible. It’s a natural response.

The Business of Cancer—‘Locking In’

Quickly upon diagnosis, oncology professionals refer to supplementary tests, additional providers, and seek to lock in your business as their patient, along with a prescribed schema of treatment (which, by the way, can vary from oncologist to oncologist).

This is the business of oncology and your purchasing power. It involves physicians and other providers, of course, but there are liaisons and administrators as well as influence through marketing, messaging, and informative collateral.

These collaborative efforts often combine for an urgency to secure commitments from patients to begin therapy. On the face of it, it is not immoral, it’s plain capitalism; this is how we currently roll in the U.S.  Welcome to America.

While initial recommendations may be appropriate and pragmatic, how sure can a ‘new’ patient be when she’s only heard from one oncologist? Viable options may not be known by that medical provider, and therefore not explored or explained.

If you are seen by a private community oncology clinic, a larger medical center, hospital, or health system—unless you host a common, early stage disease with excellent outcomes with today’s standard of care—do not allow others to lock in your business before you are 100% comfortable and ready.

Take your time. Work from your calendar, not theirs. Be the author and lead scheduler of your own calendar.

You Must Allow Time For…

Expert Second or Third Opinions

Oncologists have neither the time nor wherewithal to read every new cancer study that is published. They are not following every new drug or treatment coming down the pipeline. It is nearly impossible for them to be on top of experimental therapies, off-label drugs (those not approved for a specific disease), or all available clinical trials. Most oncologists follow NCCN Guidelines to inform treatment recommendations for specific diagnoses, and for recurrent disease.

This is why it is critical to get second, third, or more opinions from clinician-investigators at NCI-designated comprehensive cancer centers. Specifically, you must be seen in clinic by academics within these institutions that eat, sleep, and breathe the specific malignancy you may be hosting.

These are the folks running clinical trials or otherwise aware of the various activities among their peers across the country and around the globe. They are acutely aware of the drug pipeline and approval process, largely informed by the clinical trial process.

It is important to note that in many cases it will be possible to be carefully followed by the academic expert, but treated locally. Collaboration between the academic expert—who will recommend a specific therapeutic protocol—and your local oncologist, can often make it possible to get treated close to home.

[Handpicked Related Content: 3 Reasons to Get a Second Opinion at an NCI-Designated Comprehensive Cancer Center]

You Must Allow Time For…

Body and Mind Preconditioning Before Treatment

Before starting a treatment regimen—especially one that involves interventions known for causing deleterious side effects and extended recovery periods—it’s important to be thoroughly prepared for what’s to come.

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Fortunately, many targeted therapies are well-tolerated; often they have a minimal impact on day-to-day functioning during active treatment. However, the more conventional and widely used treatments today still comprise chemotherapy, radiation therapy, and surgery, which we know are typically debilitating and challenging regimens to get through and recover from.

This is why it is critical to get into the best physical and emotional shape possible prior to starting treatment. Lifestyle changes ideally begin immediately—starting with eliminating sugar and all processed and high glycemic foods, increasing filtered water intake, increasing movement with various forms of exercise, and renewing focus on quality sleep.

[Handpicked related content: The Impact of Exercise on Cancer]

You may not have been investing much time or energy in a healthy lifestyle prior to being diagnosed, but you have an opportunity now to make vital changes prior to, during, and after cancer treatment. These changes will help strengthen your immune function, provide more energy and clarity in thinking, and help ensure that, post-treatment, you will be best positioned for a deep and durable remission.

With few exceptions those going through active cancer treatment should be exercising. In the recent past oncologists would tell patients to ‘take it easy, take naps, don’t exert yourself’. But the latest research shows that physical activity during treatment helps reduce stress and anxiety, and often makes therapy more tolerable, lessening side effects.

Develop an exercise program under the guidance of your physician—or at least with the tacit understanding and support of your oncologist. Work with an exercise physiologist, personal trainer, or physical therapist who has experience working with those hosting cancer. It is vital that your exercise program is tailored to your overall health, conditioning, and the medical interventions you are preparing to undergo.

Get Your Life and Affairs in Order—At Your Pace

I’m not specifically talking about wills, plots, and funeral services, exactly, though these things are important. This is about covering the bases for your needs over a period of weeks or months, during active treatment and through recovery.

If you are caring for children, parents, pets, plants… you need coverage to ensure all are adequately cared for. If you are currently working, you must determine what and when to share, and what to ask of your employer to support your needs and situation. Whether you live alone, or share a home with family or roommates, your commitment to ensuring the best nutrition and adequate rest is paramount. It is vital to learn how to coordinate your life in a way that guarantees you are well cared for during what will inevitably be an extremely challenging stretch of time.

Smart, Measured Choices, Applied Expeditiously

Everyone’s situation is different. The point is, to every extent possible, patients must take the time to engage their reserve ‘well’ of inner strength and mental fortitude before making any firm commitments regarding cancer treatment and the scheduling thereof.

Remember, smart, measured choices eclipse quick decisions informed by limited information.

When the big picture is understood—and the propensity to rush is put aside—the best possible medical decisions specific to your unique health challenge are made. Positioning yourself—with a coordinated and pragmatic approach—will get you through the challenges of cancer treatment (and recovery) while maintaining other important responsibilities that may rest on you.

Image Credit: bigstock.com/Mihailo_K