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1. Give yourself the time you need to make your decisions… Cancers take years
to grow to the point where they are detectable. A newly diagnosed cancer patient
can therefore be confident that three or four weeks of decision analysis should
not jeopardize the effectiveness of whatever treatment is eventually-check with
your doctor to be sure. Three or four weeks of decision analysis now may prevent
years of suffering later, in cases where decisions are difficult or impossible
to reverse and costly in their implementation. Don’t let anyone rush you, including
yourself.
2. …by managing your decisions like you manage other projects in your life…
Most of our clients are accustomed to managing complex projects in their professional
and personal lives. Often, the last thing they want to do is undertake responsibility
for coordinating their breast cancer diagnosis and treatment decisions, on top
of all their other burdens. However, no one else can scrutinize their decisions
with the vigilance and self-knowledge that they bring to the task. If they do
not act to ensure that their interests are served, someone with different interests
will.
In general, unless you seize the decision-making reins, you are at risk of having
someone act in your behalf without acting in your interest. Whatever you background
or training, bring all you skills to bear on the task of managing your cancer
project. Your own established organizational and analytical skills will help
you deal with all the controversies you may encounter in a way that’s comfortable
for you. If you’re a list maker, make lists. If you like to contemplate your
other projects in solitude, make time to do that for this one, too. Approach
your cancer project with as much confidence and strength as you can muster.
3. …giving yourself permission to experiment and learn… Very few decisions
are “final” or irreversible. Many clients fret about decisions because they want
to be absolutely sure they are doing the right thing before they act. In many
cases, they fail to appreciate how much they may learn by trying some therapy.
Some are worried that once they begin radiation, IV chemotherapy (to name a couple
interruptible treatments) that they will not be allowed to stop. Those who feel
supported and confident enough to approach some decisions as reversible experiments
are often surprised at which therapies work well for them. However, some damage
from side effects may already be done by the time they stop. Patients and doctors
need to weigh that risk against the reward of discovering when an effective but
frightening therapy is surprisingly tolerable.
4. …recognizing that your preferences are unique and worthwhile… While a broad
range of information and alternatives are considered “acceptable” by people who
deal with cancer patients, some of your caregivers may have difficulty accepting
your preferences. Some will make presumptions about your preferences concerning
your quality of life, your body image, your state of mind, and other things which
they think they know better than you. If you know what you like, be wary of people
treating you as if you like-or should like-something else. You may not always
know what you like, and in that case, consulting yourself, or even others, may
make sense. The experience of cancer often leads people to change the way they
lead their lives because they realize what is really important to them.
5. …delegating tasks to people you trust… Apart from the emotional support that
you may find sustaining - and regardless of what your usual management style involves
- you may want to delegate some of the overwhelming amount of work that your cancer
recovery generates. Cancer patients often can find friends to whom they can delegate
logistical tasks necessitated by their everyday lives. It may be possible to
delegate other tasks, too, such as library or on-line research.
6. …keeping records of your case… There are at least two reasons to maintain,
in your possession, a complete record of your cancer project. First, for your
own education about your case, you will want to review it when it’s convenient
for you. Second, you will want all the material at your fingertips so that you
can give copies of it to experts whom you consult for second opinions. This is
something you should do for any report which leads people to make recommendations,
such as the pathology report.
Gathering and maintaining a complete record of your project may be one of those
tasks that you can get your friends or volunteers to accomplish. In addition,
the best investment I think anyone facing cancer decisions can make is a portable
tape recorder to audiotape the many consultations involving different specialists
who try to devise treatments customized to your case. Bring someone along to
your meetings to deal with the tape recorder if it’s distracting or troublesome
for you to do it yourself.
With audiotapes, and notes (ask for copies of notes made by any other participants
in a meeting), you begin to have the material you need to educate yourself about
your case. In addition, you may want to obtain all the records maintained by
the organizations involved in your care. Many of these records may be initially
indecipherable to you, but someone, somewhere will know how to translate them.
That sounds like a task you can delegate, too.
7. …and last, but not least, maintaining your sense of humor! Laughter cannot
be analyzed, which may be why it is so important in cancer decision-making. Everyone
needs to take a break. |