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Sunday, May 4, 2008

Giving your consent to treatment for secondary liver cancer

Before you have any treatment, your doctor will explain the aims of the treatment to you. They will usually ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should have been given full information about:

  • the type and extent of the treatment you are advised to have
  • the advantages and disadvantages of the treatment
  • any possible other treatments that may be available
  • any significant risks or side effects of the treatment.

If you do not understand what you have been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it is not unusual for people to need repeated explanations.

It is often a good idea to have a friend or relative with you when the treatment is explained, to help you remember the discussion more fully. You may also find it useful to write down a list of questions before you go to your appointment.

People often feel that the hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you. The staff should be willing to make time for you to ask questions.

You can always ask for more time to decide about the treatment if you feel that you can’t make a decision when it is first explained to you. You are also free to choose not to have the treatment. The staff can explain what may happen if you do not have it. You do not have to give a reason for not wanting to have treatment, but it can be helpful to let the staff know your concerns so that they can give you the best advice.

Multidisciplinary team

A number of cancer specialists work together as a team (known as a multidisciplinary team) to decide the most suitable treatment for a patient. This is a team of staff who specialise in treating cancer and in giving information and support. It will normally include:

  • surgeons who are experienced in liver surgery
  • specialist nurses who give information and support
  • oncologists – doctors who have experience in cancer treatment using chemotherapy, radiotherapy and hormonal therapy
  • radiologists who help to analyse x-rays
  • pathologists who advise on the type and extent of the cancer
  • palliative care doctors – doctors who can advise on treatment to relieve unpleasant symptoms and give supportive care.

Other staff will also be available to help you if necessary, such as:

  • physiotherapists
  • counsellors and psychologists
  • social workers
  • dietitians
  • occupational therapists.

Second opinion

Even though your treatment is planned by a multidisciplinary team, you may want to have another medical opinion. Most doctors will be willing to refer you to another specialist for a second opinion if you feel it will be helpful. This may take some time to organise and may cause a delay in the start of your treatment, so you and your doctor need to be confident that it will provide useful information.

If you go for a second opinion, it may be a good idea to take a friend or relative with you, and to have a list of questions ready so that you can make sure your concerns are covered during the consultation.

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