How treatment is planned

A group of health professionals with expert knowledge in anal cancer will manage your treatment. This is called a multidisciplinary team (MDT). This team will include a doctor who specialises in chemotherapy and radiotherapy, called an oncologist.

The MDT will meet to discuss the results of the tests and to plan your treatment. You may be given a choice of treatment options, which your specialist will discuss with you. If you don't understand what you've been told, let the staff know so they can explain again.

Before you have any treatment, you will need to give permission (consent) for the hospital staff to start.

It may be a good idea to take someone with you when your treatment is first explained. You may also find it useful to have a list of questions ready to make sure you get the information you need.

Multidisciplinary team (MDT)

A team of specialists will meet to discuss and decide on the best treatment for you. This multidisciplinary team (MDT) will include:

  • a surgeon who specialises in bowel cancers
  • a clinical oncologist (cancer specialist), who specialises in chemotherapy and radiotherapy
  • a nurse specialist, who gives information and support
  • a radiologist, who analyses x-rays and scans
  • a pathologist, who advises on the type and extent of the cancer
  • a stoma care nurse, who gives information and support about stoma care.

It may also include other healthcare professionals, such as a gastro-enterologist (doctor who specialises in bowel problems), dietitian, physiotherapist, occupational therapist, psychologist or counsellor.

When I started treatment, the advice from Macmillan’s Online Community was: “Listen to your body. If you feel tired, relax. Let others help. You don’t get medals for being brave.”


Second opinion

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. You may also find it helpful to have a list of questions ready so that you can make sure your concerns are covered during the discussion.

The benefits and disadvantages of treatment

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 upon your individual situation.

If the cancer is advanced and has spread to other parts of the body, 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 the cancer, deciding whether to accept it may not be difficult. However, if a cure is not possible and the purpose of treatment is 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 whether you wish to have treatment. If you choose not to have it, you can still be given supportive (palliative) care, with medicines to control any symptoms.

Giving consent

Before you have any treatment, your doctor will explain its aims. They will ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment.

No medical treatment can be given without your consent.

Before you are 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 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.

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.

Back to Making treatment decisions

Getting a second opinion

There are many reasons for wanting a second opinion about your treatment. Speak to your specialist or GP.

Making a complaint

Talking to your healthcare team can make it easier to cope. If you find talking difficult, there are things you can do.