IN CANCER care, different types of doctors, including medical oncologists, surgeons, and radiation oncologists, often work together to create an overall treatment plan that may combine different types of treatments to treat the cancer. This is called a multidisciplinary team.
Cancer care teams include a variety of other health care professionals, such as palliative care experts, physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counsellors, dietitians, physical therapists, and others.
Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patient’s preferences and overall health.
Cancer treatment can affect adults who are 65 and older in different ways. According to President of Brothers United Against Prostate Cancer, Michael Jureidini, take time to learn about your treatment options, and be sure to ask questions if something is unclear.
“Talk with your doctor about the goals of each treatment, the likelihood that the treatment will work, what you can expect while receiving the treatment, and the possible urinary, bowel, sexual, and hormone-related side effects of treatment,” Jureidini said.
Jureidini said that you should discuss with your doctor how the treatment options may affect recurrence, survival, and quality of life. It is also important to discuss your doctor’s experience with treating prostate cancer.
“These types of talks are called ‘shared decision-making’. Shared decision-making is when you and your doctors work together to choose treatments that fit the goals of your care. Shared decision-making is particularly important for prostate cancer because there are different treatment options,” he said.
As most prostate cancers are found in the early stages when they are growing slowly, you usually do not have to rush to make treatment decisions. During this time, it is important to talk with your doctor about the risks and benefits of all your treatment options and when treatment should begin. This discussion should also address the current state of the cancer.
Prostate cancer treatments may seriously affect a person’s quality of life. These treatments can cause side effects, such as erectile dysfunction, which is the inability to get and maintain an erection of the penis, and incontinence, which is when urine flow or bowel function cannot be controlled. In addition, many prostate cancers grow slowly and cause no symptoms or problems.
For this reason, many people may consider delaying cancer treatment rather than starting treatment right away. This is an approach called active surveillance. During active surveillance, the cancer is closely monitored for signs that it is worsening. If the cancer is found to be worsening, treatment will begin.
Active surveillance is usually preferred for those with very low risk, and low-risk prostate cancer can be treated with surgery or radiation therapy if it shows signs of getting worse.
According to Jureidini, treatment should begin if the results of the tests done during active surveillance show signs of the cancer becoming more aggressive or spreading, if the cancer causes pain, or if the cancer blocks the urinary tract.
If the prostate cancer causes symptoms, such as pain or blockage of the urinary tract, then treatment may be recommended to relieve those symptoms. This may include hormonal therapy. Patients who start on active surveillance and who later have a shorter life expectancy, may switch to watchful waiting at some point to avoid repeated tests and biopsies.
Doctors must collect as much information as possible about the patient’s other illnesses and life expectancy to determine whether active surveillance or watchful waiting is appropriate for each person.
In addition, many doctors recommend a repeat biopsy shortly after diagnosis to confirm that the cancer is in an early stage and growing slowly before considering active surveillance for someone who is otherwise healthy.
New information is becoming available all the time, and it is important to discuss these issues with the doctor to make the best decisions about treatment.