Practical advice for getting second opinions

A woman recently diagnosed with cancer stopped by our office to say that she’s heard that it’s important to obtain second opinions from major cancer centers and to assemble a team of experts to provide her treatment. She asked, “How the hell do I do that?” Cancer guidebooks are full of grandiose suggestions like “assemble



Cancer-Related Fatigue

When people think about the side effects of cancer treatment, they usually think about hair loss (which is common with some types of chemotherapy), and nausea (which is not nearly as common as it used to be). But in my experience, fatigue is the side effect that’s most universal and least appreciated. Fatigue is different



Decision-making with cancer

Everyone diagnosed with cancer has decisions to make. What type of treatment? Where to have treatment? Should the cancer even be treated? The question isn’t what’s best. Rather, the question is what’s best for you. After working with people making these decisions for the past several years, I’ve found that some general guidelines can be helpful:



Your doctor can’t read your mind

In the cancer world, patients often differ on what they want to hear from their doctors. Here are some examples: Some patients want to know – in detail – the various pros and cons of every treatment option, while other patients just want to know what the doctor thinks is best. Some patients want to



Why Aren’t They Doing More?

I sometimes get asked various versions of this question: “My father has advanced cancer, but they don’t seem to be treating him very aggressively. Why aren’t they doing surgery to remove the metastases in his liver and in his brain?” This is always a difficult question because the news is sometimes hard to absorb. When



Chemobrain

Some people report memory loss, slower mental processing speed, and other cognitive changes after chemotherapy. Anyone who has been in a cancer support group has heard these symptoms described as chemobrain or chemofog, but only recently have researchers and clinicians given it much attention. It turns out to be a complicated issue because so many



Second Opinions

People diagnosed with cancer sometimes ask me if their doctor will take offense if they get a second opinion. The answer is no. Nearly all doctors today are receptive to patients getting second opinions. (And if you have one of those rare doctors who does take offense, you should seriously consider getting a new doctor.)



Vacationing with Cancer

Kristina Burke is going on vacation, so she asked her oncologist to change her chemotherapy schedule. If a person has an early stage cancer and is getting chemotherapy to prevent a recurrence, oncologists usually follow established treatment protocols closely because there’s clear data to support those protocols. But Kristina doesn’t have an early stage cancer.



Keeping in Balance

Yesterday afternoon, a woman about to begin chemotherapy came into my office and asked, “What advice do you have to help me get through my treatment?” I’ve been asked this question in various forms hundreds of times. I now realize that the answer boils down to this: “Keep things in balance.” It’s all about being



Communicating with Your Doctor

I’m always struck that some people diagnosed with cancer want to know absolutely everything about their disease while others just want to be told when to show up for treatment. Some people complain that their doctors give them too much information while others complain that their doctors give them too little. Every doctor I’ve known



Cancer and Alternative Therapies

I’ve written that people with cancer often benefit from complementary or alternative therapies such as acupuncture, massage therapy and yoga. In addition to treating symptoms and reducing stress, pursuing these therapies can give patients some sense of control when their lives seem completely out of control. I recently asked a group of individuals with cancer



Waiting and Watching

Most cancer diagnoses lead to treatment within a few weeks. For some cancers, however, the recommended course of action is to delay treatment until if and when the cancer becomes worse. Many of us have heard of “watching and waiting” being recommended for some men with prostate cancer, but it also happens with other cancers,



Too Little and Too Much Treatment

Although I firmly believe that everyone should be in control of their own treatment decisions, I have observed that some people seem to seek too little treatment when they are first diagnosed and other people seek too much treatment at the end of their lives. Some people prefer to go the alternative route when they



Good Cancers and Bad Cancers

I routinely talk with people who have just been diagnosed with cancer. They’re struggling with treatment decisions and the realization that life is suddenly different. I also talk with people with advanced cancer who are coming to terms with a poor prognosis and the realization that, in all likelihood, they will die prematurely because of