Glen wrote to me regarding a treatment choice he needs to make for his slow-growing brain tumor. He reminded me that patients are challenged with decision-making every day. Sometimes it’s difficult because emotions may confuse objective thinking.

If you have a treatment decision to make, here are some guidelines to help you.

First, make a list of all your options. For example, Glen has three. His doctor recommends a difficult drug regimen. Glen learned about an alternative treatment which his doctor resists. Or he can choose not to be treated at all. That’s a choice all patients can make.

Next, make a list of the pros and cons for each option. Include the duration of the treatment, how long recovery might take, the financial cost including insurance coverage, short and long-term side effects, possible outcomes, and the probability of success; these might end up as either pros or cons.

Include aspects that are less quantifiable, too, such as the amount of pain the treatment might cause, your fear level, how far from home you need to go for treatment, or which treatment your caregiver prefers for you.

If you’re not sure whether an aspect is a pro or con, ask your doctor or other medical staff in her office for input. Get additional information from the Internet, by talking to other patients about their experiences, or from your family.

Don’t discount intuition. You may "know" one treatment is a better choice than another for you. Just be careful not to confuse your intuition with wishful thinking.

With your pros and cons list in front of you, narrow down your choices. For each final possibility, ask yourself: What is the worst thing that can happen if I undergo this treatment? And if the worst happens, can I live with it? Then make your final decision.

Share your decision with your doctor and your family. Help them understand your decision-making process, and see if they concur. Of course, the final decision is still yours to make.

Applying this process, Glen figured out he can try the alternative treatment to see if it works. His worst case is simply that it won’t, at which point he can begin the more traditional treatment his doctor has recommended.

Sharp patients know it’s their responsibility to make the right choices for themselves, and to use objectivity in the face of emotional decision-making.

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Follow Up:  Read the next column in this series:  When You and Your Doctor Disagree

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