Planning treatment for small cell lung cancer
A team of people will plan your treatment carefully.
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In most hospitals, a team of specialists will talk to you about the treatment they feel is best for your situation. This multidisciplinary team (MDT) will include a:
surgeon who specialises in lung cancers (thoracic surgeon)
medical oncologist (chemotherapy specialist)
clinical oncologist (radiotherapy and chemotherapy specialist)
radiologist who helps to analyse x-rays and scans
pathologist who advises on the type and extent of the cancer.
It may also include other healthcare professionals, such as a palliative care doctor or nurse who specialises in symptom control, dietitian, physiotherapist, occupational therapist (OT), psychologist or counsellor.
The MDT will take a number of factors into account when advising you on the best course of action, including your general health, the type and size of the tumour, and whether it has begun to spread.
If you smoke and have a lung cancer diagnosis, your doctor may advise you to try to stop smoking. Giving up smoking can have a positive effect on your treatment. Your GP should be able to offer different treatments to help you quit. Whether or not you stop should not affect the treatment plan your team offer you.
If two treatments are equally effective for your type and stage of cancer, your doctors may offer you a choice of treatments. Sometimes people find it hard to make a decision.
If you’re asked to make a decision, make sure that you have enough information about the different options, what they involve and the possible side effects. This is so you can decide on the right treatment for you.
Remember to ask questions about any aspects you don’t understand or that you feel worried about. It may help to discuss the benefits and disadvantages of each option with your cancer specialist, nurse specialist or with our cancer support specialists.
If you have any questions about your own treatment, don’t be afraid to ask your doctor or nurse. It often helps to make a list of questions and to take a relative or close friend with you.
Before you have any treatment, your doctor will explain its aims. They will ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment.
No medical treatment can be given without your consent, and before you’re asked to sign the form you should be given full information about:
the type and extent of the treatment
its advantages and disadvantages
any significant risks or side effects
any other treatments that may be available.
If you don’t understand what you’ve been told, let the staff know straight away so they can explain again. Some cancer treatments are complex, so it’s not unusual for people to need repeated explanations.
It’s a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion more fully. You may also find it useful to write a list of questions before your appointment.
People sometimes feel that hospital staff are too busy to answer their questions, but it’s important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions.
You can always ask for more time if you feel that you can’t make a decision when your treatment is first explained to you.
You are also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s essential to tell a doctor, or the nurse in charge, so they can record your decision in your medical notes.
You don’t have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.
The benefits and disadvantages of treatment
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Many people are frightened at the idea of having cancer treatments, particularly because of the side effects that can occur. However, these can usually be controlled with medicines.
Treatment can be given for different reasons and the potential benefits will vary depending on your individual situation.
In people with early-stage lung cancer, surgery can sometimes be done with the aim of curing the cancer. Occasionally, additional treatments are also given to reduce the risk of it coming back.
If the cancer is at a more advanced stage, the treatment may only be able to control it, improving symptoms and quality of life. However, for some people in this situation, the treatment will have no effect on the cancer and they will get the side effects without any of the benefit.
If you’ve been offered treatment that aims to cure your cancer, it may be easy to decide whether to accept it. However, if a cure is not possible and the treatment is being given to control the cancer for a period of time, it may be more difficult to decide whether to go ahead.
Making decisions about treatment in these circumstances is always difficult, and you may need to discuss in detail with your doctor, specialist nurse and family whether you wish to have treatment.
If you choose not to, you can still be given supportive (palliative) care with medicines to control any symptoms.
It’s important that you ask your doctors and nurses any questions you have about your treatment. The more you understand about your treatment, the easier it will be for you and them.
Your multidisciplinary team (MDT) uses national treatment guidelines to decide the most suitable treatment for you. Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion.
Getting a second opinion may delay the start of your treatment, so you and your doctor need to be confident that it will give you useful information.
If you do go for a second opinion, it may be a good idea to take a relative or friend with you, and have a list of questions ready, so that you can make sure your concerns are covered during the discussion.