Tips for Making Tough Cancer Decisions

Lori DuBenske, PhD, is a Licensed Clinical Psychologist with the UW Carbone Cancer Center. Below, she offers suggestions to help patients when faced with the need to make a decision.


You just received news that you have cancer, or that your cancer has not responded to recent treatment. Your mind is reeling. Your doctor has multiple treatment options available. But your doctor wants you to decide.

You worry: How can I possibly know what's best? How do I make sense of these statistics - the RISKS? How can I make the RIGHT decision?

For some, being involved in the decision is empowering. For others, it's anxiety provoking. For many, it's a bit of both.

But anxiety interferes with critical thinking. So the emotional situation of hearing you have cancer is actually not ideal for decision-making. You may rush to a decision just to make one. Or avoid a second opinion for fear of hearing worse news. But it is critical to take time to look at the situation from all sides. Here are some tips:

Take Time

Decide with your doctor how much time you can take to decide. Use that time. Get a second opinion. Talk about your options and concerns with people you trust - family, friends and professionals. Cancer Psychologists can also help in treatment decision-making.

Be Informed

Understand your cancer and treatment options. What is the expectation of treatment: cure, control, or symptom relief?

Analyze Benefits Vs. Risks

Potential risks come from treatment side effects, the impact on your life, and the loss of opportunities offered by treatment options you do not choose.

Understand the possible side effects and how common they are. Learn what can be done to manage side effects if they occur. Exactly what side effects you are willing to tolerate may depend on what benefits treatment offers.

How will treatment affect your life? Will you need time off work? Will your family role change? How will treatment affect your daily life? The things you enjoy most? Are costs involved? If you have other health conditions, how will treatment affect them?

Treatments affect everyone's lives differently. Your personal goals and values impact what treatments are best for you.

Communicate With Your Doctor

Ongoing communication with your doctor can help at each step of decision-making, from first hearing about options, to clarifying information and discussing concerns as you evaluate choices, to stating treatment preferences including goals and what you are willing to tolerate. Continue communication about treatment progress. Re-evaluate options and make changes as needed.

Remember You Can Change Your Mind

Sometimes it helps to think about choices in steps. When you make a choice, you are only agreeing to the first step, with the option to decide whether to continue next. For example, if you choose chemotherapy, you agree to take it one time. Then you have the choice whether to take it the next time. It is okay to change your mind during treatment.

Remember, there is no 100 percent right or wrong answer. Regardless of the outcome, you are likely to feel better about your choice if you take time to consider what's important to you and choose according to those goals and values.