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Ask Your Oncologist

Welcome to the Journey – Questions to Ask Your Oncologist

A diagnosis of cancer may bring a wide variety of emotions and feelings, among them anxiety, stress, and fear.  Very often when a patient goes to see their oncologist they are feeling so overwhelmed that they don’t necessarily hear what is being said by the doctor and, additionally, any questions the patient has they may forget.  If possible, it is always good to have one come with you to your appointments as an additional pair of ears; alternatively, a tape recorder can also be very helpful.  You should also have a pad or notebook to write down specific questions you may think of in between visits to the doctor and then when you go to the doctor you can use these items to write down notes with regard to what the doctor says during your visit. 

To assist you at this very challenging time, the following are a list of questions that have been comprised for you to bring on your visits to your doctor.  It has come to our attention that when this list of questions has been utilized it has greatly assisted patients in feeling more in control when they visit the doctor and, additionally, we have been advised that when these patients have persisted in addressing their questions – it has produced a positive outcome for them during the time they have spent visiting the doctor.

Again, first and foremost ... it is very important that you feel comfortable with your doctor ... that there is a good connection ... that he explains everything clearly, is not brusque, and does not brush aside your questions.  A very good doctor will explain everything so you can understand what he is saying and he should be very patient, understanding and compassionate about answering your questions and being supportive of you and your concerns.  You should not feel in awe of the doctor and should stand your ground until any questions you have are answered clearly and concisely without any confusion, misunderstanding, or doubletalk.

Furthermore, you may, in addition to the following questions, want to also address any nutritional issues that could be related to your overall health and/or contributing to and/or exacerbating the dynamic relating to your cancer.  For some patients this very often ties in with trying to deal with the "Why is this happening?" question.


Questions to ask:

  1. The type, stage and level of the cancer - (For example, COLON CANCER, STAGE 1-A - This could mean that it's an early stage); it’s important that you have the doctor explain it so you will understand exactly what he is saying.


  2. If the your doctor suggests radiation and/or chemotherapy - and, for example, suggests radiation first - ask why the radiation would be first and the chemo second or, if it is the other way around - ask why the chemo would be first and the radiation second – The doctor may suggest doing them both at the same time, if so, you need to know why and also ask about the potential physical impact it would have on you if your treatment is done this way. 


  3. Find out the kind of chemotherapy - the actual names of the chemotherapy medicines the doctor will be using - especially if there is more than one.


  4. Ask how often the treatments will be - i.e. once a week/ every two weeks/every three weeks and how long an amount of time the infusion will take and how long a round of treatment you will be receiving (for example it might take 3 hours for the infusion and you may have to go once a week for 8 weeks or do 6 cycles going once a week every three weeks until you have done 6 treatments. Sometimes they use a pump that releases the chemo into a patient and the patient wears it and goes home - they wear it for a certain number of days and then go back to the office - there are times when a patient wears the pump but also has some kind of infusion too - so as you can see there are a lot of different possibilities - including the possibility of having to go everyday.  Also be aware that there are also oral chemotherapies, and chemotherapies that are given by an injection. 


  5. Ask if they do blood work at the place where you will be receiving chemo - before giving you each of your chemo treatments, to determine that your blood counts are high enough for you to receive the chemo, and if your white counts or red counts are too low for treatment if they will give you shots to increase these counts so you can continue with your treatments and do they give you these shots at the same place where you go for your chemo or do you go to the doctor's office?


  6. Do they give other medications with the chemo infusion - i.e. steroid/benedryl/an antiemtic (anti nausea meds), etc?


  7. Ask about side effects:

    Hair loss

    Nausea/Vomiting -

    Sores in your mouth

    Rashes

    Diarrhea

    Constipation

    Neuropathy symptoms in fingers, hands, legs, feet

    Any other side effects:
  8. Ask if the place where you get your infusion of chemotherapy has chemo nurses who supervise the infusion and if they will be checking your blood pressure and temp and watching for allergic reactions.


  9. Find out where, if necessary, you would be going for radiation therapy, how many treatments you might require, and would you be meeting with a radiation oncologist to discuss the treatment.


  10. Make sure the doctor knows all the medications you are taking, if any, for other medical or health related issues.  If you are taking a variety of vitamins and supplements – your doctor also needs to know this information. There have been some studies that show antioxidants and other supplements can compromise the effectiveness of certain chemotherapy regimens and radiation therapy.  Additionally, you should ask about whether you can continue taking a multivitamin during treatment. A good website to utilize and share with your doctor is www.mskcc.org/aboutherbs  - this question (#10) might lead to your having a discussion with your doctor about integrative medicine – as it is important to know how the doctor feels about integrative-complementary therapies and if he supports them being used together with conventional medicine – for example, massage therapy, reflexology, yoga, acupuncture, music therapy, art therapy, etc..


  11. VERY IMPORTANT!!!  IS THERE ALWAYS A DOCTOR ON CALL AFTER HOURS FOR ANY PROBLEMS OR EMERGENCIES THAT MAY ARISE?


  12. Is there someone available during office hours so you can call them and who will definitely call you back regarding any issues, questions or need for renewing prescriptions (for example if you need an antinausea medication)?


  13. Ask what kind of supportive care the office provides - for example is there someone you (or, if needed, your caregiver/family) can call if you (or your caregiver/family) are having any concerns or problems; do they have someone that discusses what you can be doing nutritionally if you have a reaction to your treatment that causes you to have a loss of appetite or other dietary issues.


  14. Ask how often they check your tumor markers and ask the doctor to explain what the tumor markers are and what the numbers mean - and, with regard to this - how the treatment program that is being recommended will impact on these markers and an idea of the timeframe they are looking at to see a result of the treatment. 


  15. Once treatment has started - how often and/or when will they have you go for scans to see how you are responding to the treatment?


  16. Depending on how you respond to chemo – if radiation has been mentioned as a possibility, will it still be necessary for you to have radiation - or would the radiation be additional because they want to make sure all signs of the cancer have been eliminated.


  17. After your doctor has discussed the kind of treatment protocol being suggested for you – you may want to ask - "what kind of success the doctor has had with the kind of treatment plan that is being recommended?"


  18. Another question is what are the newest breakthroughs and clinical trials being done for the type of cancer you have and are you eligible for any of these treatments - and/or would they be better than the regimen the doctor is suggesting and, if the doctor is not doing these treatments would it be more successful for you to go to whatever place does do these treatments? (this question ties in with the concept of "second opinions".

    The questions suggested here should give you a place to start and a direction in which to proceed.  It is important for you to understand that these questions are a recommendation/guideline to help you when you visit your doctor. As you move forward on your journey, please feel free to add your own questions – the most important factor is to have an ongoing dialogue – one that is an open line of communication with your doctor.

    If you have any doubts or concerns and do not feel you have been given sufficient information and if you are unsure or do not feel completely comfortable in your connection with the doctor – remember – there is nothing wrong with getting a second opinion – especially since your doctor is a very important member of your team and this is your life and you need to do what is best for you and what will give you peace of mind.

    Remember – “knowledge is power” and when you take control of your life – it will empower you, support you in the success of your treatment and allow you to be an active participant (“member of your team”) in your healing process. 
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