Making treatment decisions

Friday 1 May, 2015

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On this page: Finding a complementary therapist | Can I help myself or should I see a professional? | Talking with others | A second opinion | Costs | Taking part in a clinical trial


Sometimes it is difficult to decide on the type of treatment to have. You may feel that everything is happening too fast. Check with your doctor how soon your treatment should start, and take as much time as you can before making a decision.

Understanding the disease, the available treatments and possible side effects can help you weigh up the pros and cons of different treatments and make a well-informed decision that’s based on your personal values. You may also want to discuss the options with your doctor, complementary health practitioner, friends and family.

You have the right to accept or refuse any treatment offered. Some people with more advanced cancer choose treatment even if it offers only a small benefit for a short period of time. Others want to make sure the benefits outweigh the side effects so they have the best possible quality of life.

Deciding whether to use complementary therapies and which ones to choose is a similar process to deciding on a course of conventional treatment. Some people with cancer may feel pressure from friends and family to use complementary therapies, and may feel guilty if the therapy they choose doesn’t offer any benefit.

Some people will consider complementary therapies at the time of their diagnosis; others will not think about using them until later, perhaps as part of their supportive or palliative care.

Cancer Council warns against delaying or stopping conventional treatment in favour of an alternative therapy.

Finding a complementary therapist

Contacting a professional association is a good starting point for finding a therapist. Many people find good therapists through recommendations from family or friends or through a support group. Some registered health professionals (e.g. doctors, nurses, pharmacists) are also qualified in a complementary therapy such as nutritional and herbal medicine, hypnotherapy, counselling, acupuncture or massage.

  • Confirm that the therapist is willing to communicate with your doctors about your treatment. This is particularly important if you see a practitioner who may use remedies that might interfere with conventional treatment.
  • Check whether the therapist would like to see your test results, a list of medications you’re taking, or your conventional treatment plan. This information reduces the risk of them dispensing remedies or other treatments that might interact with your conventional medicines or treatments.
  • Ask for a written treatment plan outlining the remedies and dietary or lifestyle changes recommended.
  • Keep a record of your consultations, including the treatments given and medicines or supplements you have been prescribed.
  • Write down any questions you have or use the question checklist.
  • Take someone with you to appointments to offer support, get involved in the discussion, take notes or simply listen. 

Can I help myself or should I see a professional?

One of the reasons people with cancer use complementary therapies is because it helps them take an active role in their health.

Some simple ways people can help themselves, without the guidance of a professional, include learning gentle massage or acupressure techniques, adding essential oils to their bath, meditating, or drinking herbal tea.

Some people may consider self-prescribing herbs or nutritional supplements. Although this may seem like a cheaper alternative, it may not be safe. The benefits of seeing a professional complementary therapist are that they:

  • are qualified in the therapy or medicine you are considering
  • have an objective view of your case
  • have experience treating a range of conditions and may have treated other people with cancer
  • are able to liaise with your clinicians, as necessary
  • can prepare a tailor-made treatment plan and dispense remedies based on your individual needs, if they are qualified to do so
  • can help you avoid the health risks of using complementary therapies that may interact with conventional cancer treatment.

Many websites offer a range of complementary medicines that may be less expensive than those you can purchase in Australia. However, the safety and quality regulations that apply to commercial products sold in Australia do not cover products purchased from overseas.

Keeping your health care providers informed

It is important that you let your primary health care providers (e.g. GP, nurses, specialists) know you are considering using complementary therapies. This will help reduce the risk of adverse reactions. Studies show that most people with cancer who use complementary therapies don’t discuss this with their primary health care providers because they worry their doctors will disapprove.

The use of complementary therapies to manage a range of health conditions is growing, so many primary health care providers are now better informed about them and are often supportive of their use. Some doctors and nurses have also been trained in complementary therapies and are able to give you accurate information about them.

It is important to discuss your interest in complementary therapies with your doctors and nurses, even if they aren’t supportive of their use. It allows them to consider your safety and wellbeing.

For example, your surgeon, oncologist or radiotherapist may have specific concerns, such as not using particular creams or medicines at certain times during your treatment. If you are taking herbs or nutritional supplements, they may suggest you stop taking these before, during or after particular treatments.

To keep your doctors and nurses better informed, ask your complementary therapist to provide a letter outlining the type of therapy you are receiving.

It is also important to tell your complementary therapist that you have cancer, and advise them of the treatment you’re having.

Talking with others

You may want to discuss your different treatment options with family or friends, medical practitioners, nursing staff, the hospital social worker or chaplain, your own religious or spiritual adviser, a cancer support group or Cancer Council 13 11 20. Talking it over can help you sort out the course of action that best suits you.

A second opinion

Just as you may want to get a second opinion from another specialist about your conventional cancer treatment, you might want to see a few different complementary therapists to compare how they would approach your treatment. After consulting with a complementary therapist, you may decide you don’t want to continue seeing them because you are not sure they can offer you the right supportive treatment for your individual case.

Getting a second opinion can be a valuable part of your overall decision-making process and can help you feel comfortable about any complementary treatments you choose to have.

Costs

Consultation costs for complementary therapies vary depending on the training and experience of the practitioner, the length of the consultation, and the treatment provided. The standard fee for a private complementary health practitioner is about $80 to $140 per hour, which does not include the cost of herbal remedies, essential oils, nutritional supplements or other products.

Naturopaths, herbalists and homoeopaths may dispense remedies that they mix for you, or they may sell you pre-made nutritional, herbal or homoeopathic supplements. Prices vary depending on the type of remedy and the ingredients, strength and quantity. Consider speaking to a few practitioners to compare costs.

If you have private health insurance, check whether you are eligible for a rebate on the cost of the consultation with a complementary therapist. Most funds do not provide a rebate on the cost of any remedies or supplements that you purchase. Some complementary therapies can be claimed under Medicare if you have a referral from your GP as part of a Chronic Disease Management Plan.

Taking part in a clinical trial

Funding for clinical trials or research into the effectiveness and safety of complementary therapies is limited. Because of the growing popularity of complementary therapies in Australia, the National Institute of Complementary Medicine was established by the federal government to promote research in this area of health care.

Some universities and hospitals are also involved in research and clinical trials. Your hospital or support group may provide opportunities for you to take part in clinical trials and research involving the use of complementary therapies.

Before deciding whether or not to join a clinical trial, discuss the following questions with your doctor and a qualified complementary therapies practitioner:

  • What treatments are being tested and why?
  • What tests are involved?
  • Can I take part in the trial while having conventional treatment?
  • What are the possible risks or side effects?
  • What are the possible benefits?
  • How long will the trial last?
  • What will I do if problems occur while I am in the trial?
  • Has an independent ethics committee approved the trial?

If you join a clinical trial for conventional cancer treatment, it is important to check whether using any complementary therapies could impact on the trial results. Speak to your doctor and/or complementary therapist for information. If you decide to take part in a clinical trial, you can withdraw at any time. For more information, call Cancer Council 13 11 20 or visit australiancancertrials.gov.au.

"I was on a clinical trial when I decided to see a naturopath, who suggested I take coconut oil. The doctor on the trial said it shouldn’t have an impact on my other medication."
Alan (multiple myeloma)


Reviewed by: Dr Haryana Dhillon, Research Fellow, Survivorship Research Group, Deputy Director, Centre for Medical Psychology & Evidence-based Decision-making, University of Sydney, and Chair, Clinical Oncology Society of Australia Survivorship Group, NSW; Dr Kylie Dodsworth, GP, Vice- President, Australasian Integrative Medicine Association, SA; Lauren Muir, Accredited Practising Dietitian, Peter MacCallum Cancer Centre, VIC; Shavita Patel, 13 11 20 Consultant, Cancer Council WA; A/Prof Evelin Tiralongo, Lecturer and Researcher in Complementary Medicine, School of Pharmacy, Griffith University, QLD; Gabrielle Toth, Consumer; Dr Xiaoshu Zhu, Director, Academic Program for Chinese Medicine, Senior Lecturer, School of Science and Health, and Researcher, National Institute of Complementary Medicine, University of Western Sydney, NSW.

Updated: 01 May, 2015