Someone you know is being treated for cancer. It happens. The good news is that your friends and family will often just “fit in” all the treatment drama. Recovery from surgeries which are often minimally invasive starts right after with PT. Chemo is being switched out for immunotherapies. Radiation is often delivered in days instead of weeks. Targeted therapies are everywhere and a great new way to manage diseases.

Let’s face it, after a point, it’s about quality and often when we tell a patient about a very broad, aggressive plan of care that may be toxic, but only deliver an added few months, many are opting out- so patients are also self- selecting less. Practicing for 30 years the changes I’ve seen are seismic.

At ASCO (American Society of Clinical Oncology) 2 weeks ago, Many presentations delt with just that concept. How to treat with less toxicity and greater efficacy.

So today I have a few suggestions: Get second opinions. All physicians follow national guidelines but some have access to trials that now use less treatment with similar outcomes. When recommendations are made, do some of your own research. Check out the NCCN guidelines for patients easily accessible on the web. There is no foolishness in asking a simple question. “What if I do less?” The oncologist will advise a course of action, but you must know the benefits and risks to make the best decision for you and your family.

This week, Greg and his wife arrive with an adult down syndrome child they adopted. Greg doesn’t care about himself- it’s evident his treatment is directed toward longevity for his family care. 100 year old Harriet hears plans that her 80 year old daughter is asking about. She quickly shuts it down with a fiesty, “Are you crazy? Why would I do all that?” Rob has HIV and knows healthcare all too well. He is digging deep for fortitude for a new battle, still young enough to have life to live. “Doc, I didn’t survive HIV to give up with this new cancer, bring it on”. Good.

I am a huge fan of your individualizing your own plan of care. Understanding it fully and even, like Pete, trying it out… then quitting if it’s not for you. This is your life. It is precious. Don’t let anyone railroad you once you get on the treatment train. All decisions are personal. I respect that as should your own physicians. You can even ask your oncologist, ” Is there a treatment plan that is less aggressive? Next week I will see a patient with a type of lymphoma. Interesting that just yesterday I came upon an article detailing a new protocol at MD Anderson considering 1-2 doses of radiation instead of 20. While it may not be ready for prime time (phase 3 trial or further along) changes in care are swift.

You may be retired. You may be enjoying a quiet,simpler life, but you should not become complacent. Just like decisions you made in your education, families and employment over the years, now it is healthcare decisions that will impact your future wellbeing and that of your love ones. Stay smart. Stay in control, and have a great week.