ABSTRACT
This chapter describes clear treatment policies for different types of malignant disease. These policies are based on the knowledge of the natural history of the disease and details of its extent – the clinical or pathological stage of the tumour. The three levels of decision-making used when formulating a treatment policy for an individual are: the decision to treat or not to treat; treatment intent, whether radical or palliative; and specific aspects of treatment policy regarding local, systemic and supportive therapy. Patients are increasingly well informed and wish to discuss the details of their disease and options for treatment. The diagnosis of cancer is often associated with many emotional responses, which will colour the consultation including anger, frustration, guilt and despair. Communication with a patient is affected by many factors relating to both the patient and the healthcare professional including environment, culture and content.
