How treatment is planned

A group of health professionals with expert knowledge in your type of cancer will manage your treatment. This is called a multidisciplinary team (MDT).

Your specialist will arrange some tests to find out more about your cancer. The MDT will meet to discuss the results of the tests and to plan your treatment. They will look at a number of things, including:

  • the type and size of the cancer, and whether it has spread
  • your general health
  • national treatment guidelines for your particular cancer.

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. The aim of treatment for secondary bone cancer is to control the cancer and improve symptoms and quality of life. You will need to give permission (consent) for the hospital staff to give you the treatment.

You may find it helpful to take a friend or relative to your appointments to help you remember the discussion. You may also find it useful to have a list of questions ready to make sure you get the information you need.

At the hospital

You may have a number of tests at hospital to help the doctors make a diagnosis. In most hospitals, once you’ve been diagnosed with cancer, a team of specialists will work together to plan the treatment they feel is best for your situation. This team of specialists is known as a multidisciplinary team (MDT). Depending on what type of cancer you have, it usually includes:

  • a surgeon
  • a medical oncologist (a doctor who specialises in treating cancer with chemotherapy)
  • a clinical oncologist (a doctor who specialises in treating cancer with radiotherapy and chemotherapy)
  • a radiologist (a doctor who specialises in reading scans and x-rays)
  • a pathologist (a doctor who specialises in looking at cells under a microscope and diagnosing the cell type)
  • a nurse specialist (a nurse who gives you information and support during treatment).

Before your cancer treatment can be planned, one of the specialists will see you and arrange for you to have various tests. This is to find out the type and size of the cancer and whether it has begun to spread. The MDT will then meet together to discuss the results and plan your treatment, taking into account a number of factors:

  • the type and size of the cancer and whether it has spread
  • your general health
  • national treatment guidelines for your particular cancer - you can find out more about these from your specialist.

Once your MDT has decided the most suitable treatment options available to you, your specialist will discuss the recommended treatment with you. They should always take your own wishes into consideration as well. Usually this discussion will happen during an outpatient appointment.

If you have a choice of treatments, they will give you time to make a decision about which treatment you wish to have. It’s important that, before your treatment, you feel able to ask any questions and understand the answers given.

How does an MDT work?

How the team is organised will depend on where you live - they may be slightly different across the UK. Some MDTs discuss patients from different hospitals. Specialists may be on teams for a number of different types of cancer.

How often an MDT meets may also vary. This could mean that you have to wait a bit longer to get all the results of your scans and a treatment plan from your doctor. This can be frustrating and worrying - but the pooling of different types of expertise should mean the best possible decisions are made about your treatment and care.

If waiting for results is making you anxious, you may find it helpful to talk about how you’re feeling with a partner, your family or close friends. You can also talk things over with one of our cancer support specialists on 0808 808 00 00.

Benefits of an MDT

The National Institute for Health and Care Excellence (NICE) recommend that people with cancer should be managed by a multidisciplinary team. People cared for by an MDT are more likely to:

  • receive accurate diagnosis and staging
  • be offered a choice of treatments decided by a group of experts, rather than by one doctor
  • receive better coordination and continuity of care through all stages of the cancer
  • be treated in line with locally agreed policies and national guidelines
  • be offered appropriate and consistent information (because the person giving the information should be aware of the team’s strategy for your care)
  • have their psychological and social needs considered - communication between different team members is better where they have a formal working relationship.

Giving your consent

Before you have any treatment, your doctor will explain its aims. They will usually 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, and 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.

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.

For people with secondary cancer in the bone, treatment usually aims to control the cancer, leading to an improvement in symptoms and a better quality of life. However, for some people, the treatment will have no effect on the cancer, and they’ll get the side effects with little benefit.

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.

Back to Making treatment decisions

Getting a second opinion

Your treatment will be planned using national guidelines, but you may still want another medical opinion.

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.