Knowledge is power.
A cancer diagnosis is less daunting than it used to be. For many kinds of cancer, scientific knowledge, treatments and health outcomes are continually improving. Even so, fear is often the first reaction for anyone who is told, ‘We’ve found something suspicious.’ If that suspicion is confirmed as cancer, the uncertainty about what comes next is hard to handle.
What will we cover at this appointment?
Knowing what to expect on your first visit will help ease the nerves. While making the appointment, inquire about these basics: Will a physical exam be involved, or is the focus of this visit on information and discussion? To get organized, it helps to be told what to bring — such as insurance cards, test results and reports or contact information for your primary care physician and other doctors you’ve seen. The American Society of Clinical Oncology offers a comprehensive list of preparatory questions to ask about your appointment.
Can we revisit this information later?
It’s not surprising that patients don’t fully take in all the essential information provided when they meet with their new oncologist. “If I’m overwhelmed during this visit, when can I meet with you so we can discuss or re-discuss things in greater detail?” is a perfectly reasonable request, says Dr. Wui-Jin Koh, chief medical officer for the National Comprehensive Cancer Network.
What type of cancer do I have?
Your primary care physician may have given you a tentative cancer diagnosis based on symptoms, screening test results and clinical examination findings. It’s essential to verify the precise type of cancer you have with your oncologist (or find out if there’s still any uncertainty about your diagnosis).
What is the standard treatment for my condition?
Cancer treatment choices may include monitoring or observation, surgery, traditional chemotherapy, targeted medications, radiation or immunotherapy as standalone or combination treatments. Clinical pathways and physician guidelines include treatment recommendations for most types of cancer based on disease stage and other factors. However, each patient’s diagnosis is unique, so a standard treatment option may not exist. Making decisions with your physician and having a treatment plan in place can help restore your sense of control.
Why do you recommend this treatment?
Does your oncologist expect this particular treatment to shrink your tumor, cure your cancer or put it into remission? “How could I benefit from this treatment?” is another way to ask.
Do I need additional tests?
Your oncology team pinpoints your cancer diagnosis and specific tumor type. “Especially in this day and age — when so many treatments are guided by biomarkers (biomarkers are specific molecules produced in the body of someone with cancer) — when patients are told their stage or diagnosis, an important question would be: ‘Do I need additional tests?'” Koh says. “Or: ‘Have all appropriate tests and biomarker genomic information been obtained to guide my treatment?'”
What are potential treatment hazards and side effects?
When deciding on any cancer treatment, you need to know about potential downsides. That includes common side effects that you can likely expect, as well as rare but more serious complications, Nelson says.
Who are my cancer team members?
Cancer care is rarely handled by an individual physician anymore. Typically, the multidisciplinary team includes a variety of clinicians with expertise in different care facets. Key members would usually consist of a medical oncologist, surgeon, radiation oncologist, pathologist and oncology nurses at a minimum, Koh says. Nutrition specialists and clinical social workers might also be part of the team for a given patient.
What types of nutritional and lifestyle support can I receive?
It might not be an immediate concern, but “What kind of nutritional counseling or advice can I get?” is often pertinent for patients with cancer. “Appetite changes and weight issues are very common during cancer treatment,” Koh says. “Not just weight loss — also weight gain.”
Will I be able to have biological children?
Some cancer treatments can impair your ability to have children, so it’s important to discuss fertility preservation upfront if you’re interested in having kids. In the growing field of onco-fertility, specialists work with cancer patients and survivors to maximize their reproductive potential.
Do I need to start treatment right away?
Not every type of cancer requires immediate — or any — treatment. Watching and waiting could be a reasonable choice with a slow-growing cancer that’s unlikely to affect your daily life or survival chances. For instance, prostate cancer is a condition for which your doctor may recommend active surveillance or close observation to monitor the spread of the disease.
Are clinical trials available?
With some types of cancer, you might benefit from participating in a clinical trial for a specific type of treatment. Participating in research can position you to receive promising, state-of-the-art therapy. Along those lines, Schapira suggests, you also could ask: “Are there any drugs in the pipelines that might change my treatment in the near future?”
What is my prognosis?
Getting cold, hard statistics — like average survival rates for a specific cancer diagnosis — isn’t necessarily right for everyone. However, you deserve to understand these figures if you’re interested. By asking your oncologist, he or she can put general outcome numbers into better perspective.
Should I get a second opinion?
If you don’t have local access to a specialty cancer center or academic medical center, you may still be able to benefit from that level of expertise through a one-time consultation. Your doctor may even have a suggestion of where to refer you for another opinion.
Could an outside pathologist review my slides?
Two heads can be better than one when reviewing tumor biopsy samples. Asking “do you think it would be valuable to have my pathology slide reviewed at a significant treatment center?” is a reasonable request, according to Nelson. “It’s never wrong to ask that question, and it’s easy enough to do.”
Can I get copies of my medical record and pathology reports?
Today, most cancer centers have online patient portals to allow patients to access all their medical records online, Koh notes. However, some information might not be as readily available, such as a patient’s most recent pathology report or CT scan image. This is important information to have at hand, particularly if you’re seeking an outside second opinion.
How might this cancer impact my family?
“A question that patients might sometimes forget to ask is, ‘Does this cancer have hereditary implications and how might it impact my family?'” Koh says. “We know that a substantial minority of cancers have genes that impact children, particularly.”
What will my treatment cost?
Cancer treatment can be extremely expensive. To avoid unpleasant financial surprises, ask about costs ranging from office visit co-pays to whether insurance covers your treatment and if preapproval is required. You can start with your doctor or speak with nurses, social workers and patient navigators. ASCO provides more details on cost-related questions and concerns.
Will I be hospitalized?
One practical question involves whether you’ll be treated as an inpatient or an outpatient.
Are patient navigation services available?
Receiving care in a major cancer hospital system is a challenge. Even getting from point A to point B can be confusing: Where is radiology oncology located? Why is the outpatient chemotherapy clinic on the other side of the campus? How do I find the genetic counselor’s office?
How much help do you anticipate I’ll need at home?
During treatment and recovery, you may experience issues with fatigue and mobility. You could need help with transportation to medical appointments or caregiver support as you cope with side effects. It’s helpful to consider these issues in advance, rather than in the midst of your treatment course, so you can make arrangements ahead of time.
How will treatment affect my life?
With cancer therapy, the best-case scenario is that you resume your regular family and social life, and get back to full physical activity as soon as possible. In some cases, that might not happen for a while. Similarly, while some patients can work throughout much if not all of their treatment, others need to take significant time off to undergo therapy and recuperate. (If that could be the situation for you, consider asking your human resources specialist about the Family and Medical Leave Act, or FMLA.)
Do you offer evidence-based, guideline-driven care?
Several oncology-related, medical organizations develop and continue to refine treatment guidelines and best practices based on evidence gleaned from extensive clinical research and patient outcomes data.
Essential Questions for Your Oncologist
Here’s what to ask during your first cancer-related visit with your oncologist:
More from U.S. News
Questions to Ask Your Oncologist at Your First Cancer Appointment originally appeared on usnews.com
Update 11/21/22: This story was previously published at an earlier date and has been updated with new information.