What should you consider when discussing treatment options?

When discussing treatment options with your doctor, understand that:

• Treatment is evolving. Traditionally, surgery has been the mainstay of treatment for most cancers.

  More recently, there has been a movement toward less extensive operations to treat cancer.

  For example, a generation ago, women with breast cancer were treated with radical mastectomy. Today, in many cases the breast is preserved by removing only the cancerous lump and a safety tissue margin around the cancer, and following this with radiation therapy and sometimes chemotherapy and hormone treatments. This approach can be as effective as more-extensive operations.

• Treatment options vary. Learn about your disease and the approaches commonly used to treat it.

  Some cancers respond better to radiation; others to chemotherapy or hormonal treatments. Some require one type of therapy; others a combination.

  At times, simple observation rather than treatment is enough. Some cancers present few if any symptoms and cause few problems and little or no pain. They may even remain inactive for long periods of time. Treatment in those cases usually doesn't enhance your quality of life.

  Other cancers are aggressive and will likely cause major problems. Treatment in those cases may be warranted.

  Ask what would happen without any treatment, and compare the answer with the expected results of treatment.

• Treatments have side effects. Understand what side effects to expect and what benefits the treatment offers. Then weigh your willingness to tolerate the side effects to reap the benefits.

  The goals of therapy can vary, and only you can decide what side effects you're willing to accept to achieve your goal.

  For example, if you're a young person with a curable disease, you may be willing to tolerate very severe, short-term side effects for a chance of eliminating your disease. But if you are 85 and have an incurable disease, you may decide not to accept bad side effects if the goal is to live only an additional month or two.

Ask your doctor what the treatment will accomplish.

For example, the doctor's statement that treatment will increase survival by 50 percent sounds great. But if 50 percent means increasing life from eight weeks to 12 weeks, and those remaining weeks are spent vomiting and battling nausea, weakness and fatigue, maybe you haven't gained much.