Patients and Providers Must Work Together on Treatment Options
It can be tough for patients to keep up with all the changes in health care, particularly when it comes to cancer treatment options. While these options continue to proliferate, patients and providers still face multiple challenges in terms of optimal care—everyone is unique, after all, and a treatment plan for one person may not be the best for another.
If you are diagnosed with cancer, treatment is decided based on a number of factors: Where the cancer started, the extent of its spread, your state of medical health based on your age and other health problems, what treatment options currently exist, and an understanding relationship between you and your physician.
That relationship can be key to your care. Recently, there has been a movement toward “personalized medicine,” particularly for patients dealing with cancer. While there have been impressive results in multiple forms of cancer—lung cancer is a great example—those who are found to have cancer-gene specific abnormalities should be treated with specific targeted therapies.
An example is for patients with lung cancer. One of the first things we’ll do is conduct genetic testing to seek particular genes that may affect how the cancer grows. For those with an “actionable mutation,” oral medications such as Tarceva may help. Those without such mutations should be treated with more conventional therapies, including chemotherapy or radiation therapy.
However, even conventional therapies can be tricky as there are new immune-based therapies which are potentially just as effective—if not more so—allowing a patient’s own body’s immune system to recognize the cancer and try to get rid of it without the toxicity.
How do we choose the right course of action? So many factors go into medical decision-making. One of the most important is a mutual understanding between the patient and physician. Everyone has a specific goal for their lives, and much is rooted in their relationships with their families, friends, community, faith, and prior experiences. Frequently, these issues become more important in making a treatment decision than some of the biologically driven ones.
In the field of oncology, new breakthroughs are allowing providers more options in tailoring care to the patient. Having worked in the field of oncology for a while, I see many patients who come in with instructions from a previous doctor who maybe didn’t get a strong sense of what the patient wanted. It’s important for patients and providers to have conversations about what’s important to them and their families in terms of care, quality of life and potential outcome. There’s no computer algorithm to follow when it comes to patient care: It’s about discussion, education and building a relationship.
At ThedaCare, we are dedicated to providing quality healthcare to the region, improving the lives of families and communities as a whole. Oncology is a highly complex, rapidly evolving field. Much has been gained in terms of our overall understanding about the biology of cancer, though clearly each cancer represents a unique process. Equally as clear, we as humans are all unique individuals. I believe the best way to treat cancer is to recognize the individual nature of each person, make a concerted effort to define the aspects of each person’s illness, and to allow for an open dialogue in terms of available options and expectations related to each proposed treatment.
As always, patients can find more information about cancer care at www.thedacare.org/cancercare.
Thomas Klinkhammer, MD, is a hematologist and oncologist with ThedaCare Cancer Care in Appleton and Berlin
