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For cancer, there are frequently multiple treatment options with differing effectiveness, side effects and duration of treatment.

The most effective treatment with the least side effects wins, but there may be trade-offs. For example, with breast cancer, under some circumstances a woman can choose between lumpectomy (removal of just the tumor and some surrounding tissue) with radiation or mastectomy without radiation. Both procedures have very similar effectiveness.

Your doctor can walk you through the benefits and risks for each. In most cases you will be presented with relapse and overall survival statistics for a time period after treatment such as 5 or 10 years depending on the particulars of your diagnosis.

These numbers help you choose the treatment that is statistically best. But keep in mind that these are still just statistics and you are not a statistic. Don’t let the numbers bring you down.

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In addition to FDA-approved therapies, there are clinical trials that are worth considering. Enrolling in a clinical trial not only moves us closer to finding an answer to cancer but may also offer an opportunity to benefit from a new therapy.

Some clinical trials also present risks so it’s important to weigh the benefits and risks before signing up.

Your doctor will walk you through the decision process. You can find a list of all the current FDA-approved clinical trials in the U.S. at

You have the option of getting a second opinion, a valuable service that is underutilized because patients feel that seeking one would offend their doctor.

Second opinions are a normal part of cancer care, and they provide you with an opportunity to have another pair of eyes look at your diagnosis and treatment to see if there is something better or different that should be considered. The process is simple, happens quickly, is usually covered by insurance and no one will be offended. The reviewing doctor’s office will help you get a copy of your records sent.

The second opinion can have three possible results. The first, easiest and most common is agreement with the planned treatment.

The second, not uncommon, response is a recommended plan that is different but with equivalent effectiveness. If, however, the reviewing doctor recommends something very different, you need resolution. This doesn’t happen often and is most frequently settled by the two doctors speaking with each other. If that doesn’t work or isn’t possible, then you need a tie breaker.

For your third opinion you may want to consider a larger cancer center. If travel is an obstacle, some reviews can be done without the patient present.

You are now ready to start treatment with confidence.

For more information about selecting a cancer treatment plan including clinical trial details, see my blog at

In next week’s column, we will look at survivorship including complementary and alternative medicine strategies.

Dan Labriola, N.D., is director of the Northwest Natural Health Specialty Care Clinic and medical director for naturopathic services, Swedish Medical Center’s Cancer Institute.

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