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NCCN Guidelines for Patients



Breast Cancer – Metastatic (STAGE IV), Version 2.2017


Making treatment decisions

It’s your choice

Having cancer is very stressful. While

absorbing the fact that you have cancer,

you have to learn about tests and

treatments. In addition, the time you have

to accept a treatment plan feels short.

Parts 1 through 3 described the cancer

and treatment options. Part 4 aims to help

you make decisions that are in line with

your beliefs, wishes, and values.

It’s your choice

The role patients want in choosing their treatment

differs. You may feel uneasy about making treatment

decisions. This may be due to a high level of stress.

It may be hard to hear or know what others are

saying. Stress, pain, and drugs can limit your ability

to make good decisions. You may feel uneasy

because you don’t know much about cancer. You’ve

never heard the words used to describe cancer,

tests, or treatments. Likewise, you may think that

your judgment isn’t any better than your doctors’.

Letting others decide which option is best may make

you feel more at ease. But, whom do you want to

make the decisions? You may rely on your doctors

alone to make the right decisions. However, your

doctors may not tell you which to choose if you have

multiple good options. You can also have loved

ones help. They can gather information, speak on

your behalf, and share in decision-making with your

doctors. Even if others decide which treatment you

will receive, you still have to agree by signing a

consent form.

On the other hand, you may want to take the lead

or share in decision-making. Most patients do. In

shared decision-making, you and your doctors

share information, weigh the options, and agree on

a treatment plan. Your doctors know the science

behind your plan but you know your concerns and

goals. By working together, you are likely to get a

higher quality of care and be more satisfied. You’ll

likely get the treatment you want, at the place you

want, and by the doctors you want.

It’s a fine line between advocating

for myself with my treatment team

and wanting to be viewed as a good