Cancer is scary, and doctors sometimes sound as if they’re speaking a foreign language when talking about the disease and its treatment. But “people are making life and death decisions that may also affect their survival  and  they need to know what they’re getting themselves into,”  says  Dr. Angela Fagerlin,  Associate Professor of Internal Medicine at    the University of Michigan Medical School and a cancer researcher at the school. “Cancer treatments and tests can be serious.  Patients need to know what kind of side effects they might experience as a result of the treatment they undergo.”

What can cancer patients do to increase their fluency in the language of cancer?

• 1. Insist on plain language

  Don’t understand something your doctor says? Ask him/her to give a better explanation.

  “Doctors don’t know when patients don’t understand them, says Dr. Fagerlin.        “They want patients to stop them and ask questions.”

• 2. Focus on the absolute risk

  Cancer care can be risky, so it’s important to learn the facts about risks before you consent to any cancer test or treatment. Sometimes doctors talk about relative risk, saying things like “This drug will cut your risk in half.”  But such statements don’t really indicate what you need to know,  and research has shown that using relative    risk makes both patients and doctors more likely to favor a treatment, because they believe it to be more beneficial than it actually is.

  For a true picture, ask your doctor about the absolute risk of any treatment he/she recommends. “The drug will lower your risk of cancer from 4 percent to 2 percent”   lets you know that most people won’t get cancer regardless.

• 3. Visualize your risk

  Sometimes it’s hard simply to think about risk numbers. So Dr. Fagerlin recommends drawing 100 boxes  and  coloring in one box for each percentage point of risk.  If your risk of a side effect is 10 percent, for example, you would color in 10 boxes.

  This kind of visual representation, called a pictograph, can help you better understand what the numbers mean.

• 4. Think of risk in terms of frequency

  What does it mean, exactly, if a doctor says 60 percent of men who have a radical prostatectomy will experience impotence? Imagine a roomful of 100 men. Sixty will have this side effect and 40 will not.  Thinking  of  risk in terms  of groups of people helps make complicated statistics a bit easier to understand.

• 5. Focus on additional risk

  When evaluating a proposed treatment, it’s important to compare the risk of  something happening if you get the treatment versus the risk of that if you forgo the treatment.  For example, say a doctor says the risk of experiencing a certain medical problem if you take a drug is 7 percent. If you didn’t take the drug, is there a chance you’d still experience the problem?

  Always ask what the additional or incremental risk of a treatment is. “You want to make sure the risk number you’re being presented is the risk due to the treatment    and not a risk you would face no matter what,” Fagerlin says.

• 6. Pay attention to all your doctor says

  Studies have shown that the last thing a doctor tells you in a conversation is likely to   be the thing you are most likely to remember.  When you’re making a decision about treatment, it’s essential that you remember all the facts and statistics you’ve heard.

• 7. Write it down

  One great way to keep track of everything you’re told is to write it down. At the end     of the discussion with the doctor, ask him/her if a written summary of the risks and benefits is available – or ask the doctor to help you prepare a written summary of the information.

• 8. Don’t get hung up on averages

  Picking appropriate care for cancer involves playing the odds. But studies suggest that learning the average risk does not help patients make good decisions about what’s best for them. Your risk is what really matters – not anyone else’s. Be sure to focus on the information that applies specifically to you.

• 9. Consider possibility that less is more

  Too much information can be overwhelming. In some cases, there may be many treatment options but only a few that are truly germane. Ask your doctor to narrow  down and to limit his/her discussion to the options and facts most relevant for you.

• 10. Consider your risk over time

  Your risk may change over time. If you’re told the five-year risk that your cancer will return after a certain treatment, ask what the 10-year or 20-year risk is. In some cases, the data might not be available – but always be mindful of the time frame involved.

Attitude as mind-body therapy:

1) Indecision is your decision take responsibility for your health.

I don’t mean to sound trite here. You make all decisions about your body. Your doctor   and others can make recommendations but you are the final say. There was a fundamental shift in my thinking when I decided that my oncologist was no longer in charge of my cancer, the fall of 1997.

2) Find a sense of purpose-

There has got to more of a goal for you than remission or even a cure. It can be seeing   your daughter/son graduate/marry, it can be achieving a goal within an organization, it can be most anything. But the purpose has got to be more than your health. For me it is PeopleBeatingCancer. Researching and writing about cancer, coaching cancer patients, survivors and caregivers, all of it is extremely gratifying for me.

3) Understand and live positive psychology-

This is not about being cheerful or thinking happy thoughts. The field of Positive Psychology described by Dr. Martin Seligman in the video linked above brought a fundamental shift in how I thought about the ups and downs that come with cancer (explanatory style).

4) Grow spiritually-

Please notice that I didn’t say to become spiritual or “you need some churchin’ up”     (Blues Brothers-Cab Calloway). I said to “grow spiritually.” The simple experience            of facing death will help you grow spiritually.

5) Be Proud to be a cancer survivor–

The two cancer philosophies that I disagree with most often are “Cancer as war or She beat cancer to the end…” and “I don’t want people to define me by my cancer…” I feel the exact opposite. I look at cancer as a chess match, as if I need to out-think cancer, not beat it.

Further, I’m proud of my scars, both mental and physical. I no longer sweat the little stuff. I’m more spiritual. I give more. Has cancer made me a better person???

Practicing mind-body therapy in your daily life-

6) Moderate Daily Exercise–

In many ways, moderate daily exercise is the ultimate mind-body therapy. Before, during and after active therapies, countless studies prove that moderate exercise changes how your genes express themselves, help you loose weight, help you sleep (see #8), just feel better…

7) Be social-

Whether in a marriage or a committed relationship, cancer survivors live longer if you and your primary caregiver are partners.

8) Quality sleep-

Some the most commonsense therapies can be the most effective for cancer patients and survivors. A good night’s sleep for instance.The articles linked above cite that sleep is difficult during therapy and lack of restful sleep may worsen your cancer.…

9) Relaxation techniques-

Breathing exercises, mindfulness, meditation, massage, aromatherapy, sauna-                   I consider all of these as being relaxation therapies…

10) Psychotherapy-

It took me a few years to figure this out but talking to others about my cancer their experiences helped me a lot. I still have “a bit of the doubt drifting around my head       but talking to others on FACEBOOK has helped me tremendously realize what is important for me.

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