In this episode, Dr Louise Newson is joined by a long-time friend, retired consultant urologist, Steve Payne. Together they discuss Steve and his wife Jan’s experience of her breast cancer and subsequent treatment that led to estrogen depletion. Steve describes the decision-making process they went through as a couple when Jan’s quality of life deteriorated due to severe urine and kidney infections, as well as other symptoms relating to a lack of estrogen. The experts talk about how some people’s experience in cancer care clinics can fall short of patients and their partners being given full and balanced information into how cancer treatments will affect your hormones and what this potentially means for your quality of life. Steve shares his honest reflections and insights about cancer care clinics and offers invaluable advice for those navigating these complex and confusing decisions at such a difficult time. Steve’s advice for making decisions about cancer treatments: Ask what the benefits, and especially the downsides, of the treatment are. It is key that you understand all the pros and cons of a treatment being recommended to you. If it’s treatment for cancer, ask about the pure cancer survival rates – once deaths from other causes have been removed from the data – to make sure you know the actual level of survival benefit that the suggested treatment offers. If you’re having side effects from breast cancer treatment due to a lack of estrogen, have a discussion about the pros and cons of taking HRT, for your particular type of cancer. Ask how taking HRT could improve your daily life and wellbeing and what benefits HRT offers for bone and heart health in the future. Ask how would taking HRT affect your pure cancer survival rate. Steve has written more about his and Jan’s experience and offers practical advice here, along with a new factsheet about making informed decisions during cancer care.