Balancing Cancer Treatment Risks vs. Rewards: A Patient’s Guide to Quality of Life

One of the first phrases that a new cancer patient often hears is "risk vs reward." This refers to the risk of side-effects versus the reward of feeling better or living longer.

The decisions about what type of treatment option to choose can be difficult, especially with the negative cultural images often associated with surgery, radiation, and chemotherapy. There are a lot of people who still believe that cancer treatment equates to "slash, burn, and poison," even though modern medical advances have improved all of these methods dramatically. But this is not to say that treatment is always easy. Trade-offs exist and should be considered seriously.

How patient stories inform treatment decisions

One way to weigh your options is to read personal stories from other patients. However, be careful. Some stories may give an outdated view of what cancer treatment is like.

Advances in cancer treatment happen very quickly these days. New drugs and tools come out every year and innovative technology is introduced at a rapid pace. Software updates can make machines quicker and more precise. New diagnostic tools are expanding the ways in which treatment is approached. Doctors are also more skilled and educated now than ever before.

Managing the side effects of therapy

Almost every form of cancer treatment has some downsides. Some patients will have few side-effects, perhaps limited to a bit of fatigue. Others will see major changes to their skin and hair, their muscles, or their sleep patterns. These side effects can make it hard to work or perform daily tasks. But most of these side-effects are limited to the duration of treatment. For any lasting effects, you must decide if the trade-off is worth the extra years of life.

Real-world examples of treatment trade-offs

For example, I know of a gentleman in his 80s who endured radiation for throat cancer in his 60s. He now has no functioning salivary glands and must be careful to drink often and avoid dry foods, but he is alive and happy twenty years later.

It is impossible to know exactly how your body will respond or how severe any side-effects might be. We make the best plans that we can, hope for the best, cross our fingers, and jump. The job of an oncologist is not easy, and sometimes helping a patient navigate the trade-offs of treatment is challenging. Second opinions are especially useful in this regard, especially when the options may not seem particularly appealing to a patient.

Finding the balance between risks and rewards

Deciding on a cancer treatment plan is a very serious task. For most cancer patients, the rewards far outweigh the risks of treatment. But the balance of trade-offs for any treatment can only be assessed with clear communication and a good understanding of the elements involved.

Overcoming fear and setting realistic expectations

Fear rooted in the outdated narrative of cancer treatment, can be a patient's worst enemy. On the other hand, blind optimism can be detrimental, too, potentially leading to an ordeal the patient might not be equipped to endure.

In some cases, it is a gamble that the patient must decide to take. Other times, there is a wealth of evidence to ensure everyone that the choice is clear. Every patient is unique. There is no way to predict results with 100% certainty. We have to remember that the easier path is not always the better path. Sometimes the trade-offs we make mean facing more discomfort in the short-term because of the chance for an improved quality of life and a longer time to enjoy it.

Editor’s Note: We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.