What to Ask Your Oncologist When Diagnosed with Cancer?

The moment you are told you have cancer is a moment most people never forget. A rush of emotions come and your whole world is turned upside down.  So while you are struggling to just cope with the word cancer, you are already scheduled for appointments and about to meet with your oncologist for your first consult. With a millions things on your mind, that first meeting can seem like a complete blurr. Here are a couple of questions you should always ask your oncologist when the world just seems like it isn’t making sense.

  • What type of cancer do I have? Cancers are named based on the cell type and location it first originated from. If the cancer spreads, the name of the cancer will still relate to the site where it originated. For example, if a breast cancer has traveled to the bone it is called metastatic breast cancer (not bone cancer). It will be treated using breast cancer drugs not bone cancer drugs, since the cells originated from the breast.
  • Where is it located, and what is the extend of the spread? Cancer can be confined to a local area or can spread throughout the body. Smaller, well defined tumors are often curable by surgery alone, but tumors that have spread to surrounding tissues or metastasized to different sites in the body are more aggressive and will require more aggressive treatments.
  • What stage is my disease?Staging is a way to evaluate the spread of a cancer. Each type of cancer is staged a little bit differently, this is why some doctors will order biopsies or imaging (including CT or CAT scan or MRI) depending on the type of cancer they are trying to stage. When staging is completed, oncologists and pathologist look at not only the exact location of the cancer but they will also evaluate if lymph nodes or different sites are also involved. Sometimes they will find only microscopic cancerous cells. Although I mentioned that every cancer is stage slightly differently below is the basic guidelines for staging:
    • Stage 1: tumor is small and localized (it has not spread beyond its original location).
    • Stage 2: Tumor is large but still localized
    • Stage 3: Tumor is pushing against or penetrating into nearby tissues.
    • Stage 4: cancer cells have spread to tissues at distant sites/organs in the body. Another way cancer is staged is using the TNM system.
      1. T = primary tumor
      2. N = lymph node involvement
      3. M = distant metastasis
        1. Example: left breast infiltrating ductal carcinoma staged as T1, N0, M0 indicates the tumor is small, has no lymph node involvement and has not metastasized.
  • What other characteristics does this tumor have?
    1. Each cancer is different and the level of cell differentiation will help your doctor estimate the aggression of your tumor. For example, the less a tumor resembles normal healthy tissue, the harder it is to treat and the more aggressive your treatment plan will likely be.
  • What are my treatment options?
    1. While there are certain clearly defined treatment protocols based on your cancer type, each cancer is unique, which means each treatment protocol will likely be unique as well. Ask your oncologist about ALL your treatment options, including those that may be available through other healthcare providers, or even through treatment centers in another city. You need to be provided with ALL your options so you can make the most educated decision that makes sense to you and your needs. Although the day you are provided treatment plans might have seemed like a moment out of a movie, where you are having an out-of-body experience, watching yourself try to listen to the millions of things that are being told you to, it is extremely important to take your time and ask as many questions as you can think of while you are with the oncologist. When you go home, there will likely be a well-meaning friend or relative who may try to sway your decision based on their experience in the past. Remember that many advances have been made in cancer treatments and their “bad experience” may not be a proper depiction of how treatment is today.  Make sure to ask your oncologist about the success rate for each treatment plan provided. Most treatments have been well-studied and their efficacy has been documented. (Remember each person will respond to treatment slightly differently but at least it will give you a basic idea).
  • Are there any new drugs or treatment options available for my type of cancer?
    1. One thing to consider it taking part of a clinical trial. A clinical trial is a scientific study designed to evaluate the safety and efficacy of a new drug. However, because it is still under evaluation, the efficacy will not be fully understand prior to you part taking in the trial.

Other Tips:

  • ALWAYS GET A SECOND OPTION – The idea is to evaluate all your options; this includes getting a second option. This will not only allow your diagnosis to be evaluated twice but it will also allow you to determine as many treatment options as possible. The idea isn’t to pin one doctor against the other, the goal is instead to provide you with the most amount of treatment options. You might also want to seek guidance and new information involving integrative treatment approach. This includes working with a naturopathic doctor trained to integrative cancer care.
  • Choose a physician who is right for you – when meeting with your oncologist make sure you feel a good genuine connection. This person will be part of a huge journey and you will need to feel completely comfortable with that person.
  • Make every appointment count – With our standard healthcare model pushing for physicians to keep their appointments short, make the most use of your time by coming prepared with questions to ask your physician. This will make the limited time you do have with them more valuable.

 

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