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Colorectal Cancer: Managing Your Medical Care: Once A Treatment Decision Is Made


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Now that a treatment decision has been made:learn

  • Trust your doctor and your treatment plan.
    • If for some reason you don't trust the proposed treatment plan, continue to explore the alternatives until you have more trust.  Keep in mind that in making a treatment decision it is rare to approach it with complete confidence.
    • If you don't trust a member of your team, change him or her.  For information about how to switch doctors, click here.
    • Keep in mind that trusting a doctor does not mean that you should stop asking questions, raising your concerns, working with the doctor in a partnership. If there isn't time to ask all your questions during an appointment with the doctor, ask when and how to ask your additional questions. For instance, the doctor may take additional questions by email, or come in early or stay late.
    • If the answers to your questions cause you to rethink your treatment, contact your doctor immediately.
  • If you have more than one doctor, one should be in charge. Hopefully your doctors will work together cooperatively. 
    • Do not assume that a particular doctor is in charge. Confirm with the doctor you think is in charge that he or she has taken on the role. As your situation changes, check again.
    • If the doctor who takes the position is not the one you want to be in charge, ask another doctor to fill the role.
    • Who is in charge generally depends on:
      • If the institution you are being treated at has a team in place with assigned roles. Large centers and Comprehensive Cancer Center’s offsite link utilize the team approach.
      • The nature of the illness
      • Which doctor you need to see most frequently
      • Who knows your history well
      • Who is willing to act as leader
    • See: Doctors 101: Choosing, Working With Effectively, Switching, Paying
  • Set doctor appointments and treatment schedules that work for you.
  • Focus on the medical preparation to take treatment.  For instance, there may be medications that you should stop taking for a while. For instance, if you will undergo radiation, expect to meet with your radiation oncologist before treatment starts.
  • Start thinking about the practical aspects of your upcoming treatment.  
    • By preparing now, you can avoid the stress of catch-up at the same time you are dealing with treatment.  For instance, review the likely side effects of the treatment(s) and start planning for them now.
    • If you work, start making plans for time off and for any changes which may be required while you undergo, or recover from, treatment. For information, see: Newly Diagnosed With Colorectal Cancer: At Work.
    • Think through your personal needs
      • If you will be unable to carry on your normal responsibilities or chores, start making arrangements for other people to take them over.
      • If you plan to travel, get approval from your doctor. For tips about choosing a destination, means of travel, how to prepare etc, click here.
    • Taking action can also help get you through what is usually a difficult emotional time before treatment starts. The period prior to the beginning of treatment is usually one of the most stressful periods after a diagnosis. (Tips about dealing with waiting are available by clicking here. For tips about dealing with fear of a treatment, click here.) 
  • Get an oral check-up and take care of any existing problems. Oral infections can have a negative impact on treatment. For information about oral care, click here.
  • Consider who to disclose information about your condition and/or treatment, and what to tell them. Once information is out of the bag, you can’t take it back. Tell children in an age appropriate way. For tips, click here
  • If you have children, brothers or sisters, a natural question is whether they are at risk for also developing colon or rectal cancer, and, if so, what should be done about it.
    • 17-20% of colorectal cancer is hereditary which means that certain identifiable genes are passed from a parent to a child. The rest of cases are not gene related and thus do not affect children or brothers and sisters (siblings).
    • The genes which increase the risk of children getting colorectal cancer are FAP familial adenenomatous polyposis and lynch syndrome or HNPCC.
    • There are currently two tests for the subject genes. If a test shows that one of the genes is present, a genetic counselor should be consulted to decide what to do.
    • The number one reason for surviving colorectal cancer is early detection.  Recommendations depend on your age when diagnosed.
    • If a person is under age 50 when diagnosed, the standard  recommendation is: That a colonoscopy be performed, and that a genetic test should automatically be done. If one of the genes is present, children, brothers and sisters should be tested without undue delay.
    • If a person is age 50 or over at diagnosis, (unless there has been a genetic test which shows the presence of one of the subject genes), children, brothers and sisters should be screened for possible presence of colorectal cancer starting ten years before the age of the diagnosed relative, or at age 50, whichever comes first. To clarify, if you were diagnosed at age 52, then your children, brothers and sisters should start being screened for colorectal cancer at age 42. How often the person should be screened after the initial test will be determined based on the initial findings. For information about screening techniques, click here
    • If  you have children: In addition to following the above recommendation, start changing your children’s diet to a cancer prevention diet and make sure they get at least 30 minutes of exercise each day. These steps will help reduce the risk of  colorectal cancer. If it does appear, their bodies will be in the best shape to fight it.
  • Travel is likely possible now and during treatment if you make appropriate arrangements and take necessary precautions. Clear all travel with your doctor before you set plans. For information about travel after a diagnosis, click here.  For information about travel with an ostomy, click here.
  • Consider how you are going to pay for treatment. To learn how, see How To Maximize Use Of Your Health Insurance and Colorectal Cancer Finances.
  • Start compiling a copy of your medical records, and get your other papers organized so you can save time finding things – especially when you’re not feeling well.
  • Keep control of your medical care in case something happens and you become unable to communicate by executing easy-to-obtain documents known as Advance Health Care Directives and Advance Mental Health Directives. If you executed such documents more than a year ago, update them so there is no question about your current desires.
  • Deal with emotions that surface. The body and the mind are part of the same system. If you become so anxious and frightened that you become unable to think straight or take action, consult with a mental health professional who can help reduce anxiety enough so that you can participate in the decision. For tips about dealing with emotions, click here.
  • Last, but certainly not least, start adopting a cancer prevention diet and lifestyle. 
    • A cancer diet, exercise and rest will help strengthen your system to be better able to tolerate treatment, help you feel in control, and ultimately help you remain cancer free if treatment gets rid of your cancer or to maximize your efforts if the goal becomes living with your  cancer as a chronic disease.
    • It may help to think of food as one of your medicines.
    • Do not expect to change the way you eat, drink and live overnight. Baby steps get you to the same place as a sprint – with more likelihood that you will be to keep to the new lifestyle.

For additional information, see:

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