Too Little and Too Much Treatment

Bob Riter is the retired Executive Director of the Cancer Resource Center. His articles about living with cancer appeared regularly in the Ithaca Journal and on OncoLink. He can be reached at

A collection of Bob’s columns, When Your Life is Touched by Cancer: Practical Advice and Insights for Patients, Professionals, and Those Who Care, is available in bookstores nationwide and through online retailers such as Amazon and Barnes & Noble. All royalties from the sale of the book come to the Cancer Resource Center.

Although I firmly believe that everyone should be in control of their own treatment decisions, I have observed that some people seem to seek too little treatment when they are first diagnosed and other people seek too much treatment at the end of their lives.

Some people prefer to go the alternative route when they are first diagnosed. I’m a fan of many alternative treatments such as acupuncture, nutrition-based therapies, massage therapy and other modalities. These treatments can often complement conventional treatments and contribute to a person’s well-being, but they don’t replace conventional treatment if one hopes to be cured.

I’ve heard people say: “I’ll try the alternative treatment first. If it doesn’t work, I’ll seek conventional treatment.”

This is a concern because the best chance to cure a person’s cancer is at the beginning. If you delay conventional treatment for six months or a year, you might lose that one window in which a cure is possible.

A decision might be made to not have any treatment when diagnosed with cancer. Perhaps the benefits of treatment are outweighed by the risks of treatment, or perhaps the patient just wants to take his or her chances with whatever may come. This can be a reasonable approach. My concern is when people want to be cured, but opt for alternative treatment rather than conventional treatment when seeking that cure.

I also hear people say, “Well, I’ll have surgery, but I won’t do chemotherapy or radiation because I’m philosophically opposed to them.”

It’s important to keep an open mind and not decide prematurely. Don’t box yourself into a corner based on philosophy or generic understandings. Ask your doctor about the potential benefits and potential harms of chemotherapy and radiation in your specific situation.

While I see people sometimes under-treat cancer when first diagnosed, I often see people over-treat cancer towards the end of life. Once cancer has metastasized (spread to other parts of the body), a cure becomes unlikely. Treatment is designed to control the cancer and prevent it from getting worse. Each treatment that’s tried eventually becomes ineffective because the cancer mutates or changes. When that happens, a new treatment is attempted.

Sometimes people think they have to keep treating their cancer – fighting their cancer – until the very end. They don’t. Living a little longer when you feel miserable isn’t a good tradeoff in my mind.

You can ask your doctor how long a proposed new treatment will extend your life and what the side effects might be. The doctor can’t answer with 100 percent certainty, but should be able to provide some general guidelines as to what you can expect.

Decisions regarding cancer treatment are often difficult. In spite of what I say in this column, these decisions aren’t necessarily rational. Your life is more complicated than I or anyone else can imagine.

Whatever you decide, know that you have the right to make those decisions and that those involved in your care will respect them.

Further, know that you have the right to change your mind at any time. You are the one in control.

Reprinted with permission from the Ithaca Journal.

Click here for all of Bob’s columns



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