If you or a member of your family has been diagnosed with cancer you’ll have hundreds of questions fly through your mind including; is this a death sentence? You won’t know where to start getting answers. One of the resources you have will be your doctor or doctors when you have more than one, which is highly likely. However, it is difficult to trust them if you haven’t talked to them and if you haven’t asked them any questions. We have prepared a list of items you might want to know. It isn’t imperative that you ask all of the questions on our list, but this will get you started. You will not only started gaining information, but you will begin trusting your doctor. You can print this list off, or you can copy the questions that you want to use onto a notepad or tablet, and take them to your doctor’s appointment.
1. What is the actual diagnosis?
Without knowing the actual diagnosis, it is easy to be misled as you search general cancer topics. Remember that not all treatments are the same and while getting information about YOUR cancer is essential, it is even more important to make sure the information you are gathering is specific to YOUR type of cancer. Based on the information you get, you may want to get a 2nd opinion or even a third.
2. How did you determine what type of cancer I have?
There are many things doctors can do to determine whether a person has cancer. Some of the tests may have already been performed but some may have not. Here is a list of possible tests you may need Blood tests: Blood tests can tell your doctor a lot about your overall health. Biopsy: A biopsy is where the doctor will take a small piece of tissue from where the cancer seems to be. The tissue is then checked microscopically for cancer cells. CT or Cat Scan: A CT scan uses X-rays to make detailed pictures of your body. CT scans can be used to help do a biopsy and can show if the cancer has spread. Ultrasound: For this test, a small wand is moved around on your skin. It gives off sounds waves and picks up the echoes as they bounce off tissues. The echoes are made into pictures on a computer screen. These echoes used to help find cancer and to see if the cancer has spread. MRI scan: Uses radio waves and strong magnets instead of x-rays to create detailed pictures. MRIs are helpful in looking at the liver, brain, and spinal cord. Chest X-rays: May be done to see if the cancer has spread to your lungs. PET Scan: PET Scans use a special kind of sugar that can be seen inside your body with a special camera. If there is cancer, this sugar shows up as “hot spots” where the cancer is found. This test looks at the whole body. It can help if the doctor thinks the cancer has spread but doesn’t know where it is specifically. You may want to follow with questions about the specific tests.
3. What stage and grade is my cancer at right now?
You have probably heard people say things like “It was stage four cancer.” Now that is very descriptive but not informative. Cancers are graded primarily in three ways:-Number one is identified by the letter “T” and indicates the size of the tumor. T2 would mean the tumor is around 2 centimeters a T3 would be approximately 3 centimeters and so on. Number two is identified by the letter “N” and identifies the number of nodes involved. N3 would represent that cancer has been found in three different nodes. Number three is identified by the letter “M” and indicates whether or not cancer has metastasized into other areas of the body. M0 would indicate that cancer has not metastasized anywhere else in the body. Your doctor might respond that your cancer is a T2 N1 M0. That would mean the cancer is about 2 centimeters, and has been found in one node but has not metastasized anywhere else in the body. Your doctor will now refer to a chart with those grades to find out what stage those grades fit. Cancers are graded into four different stages 0,1,2,3 and 4. Stage 0 is also called carcinoma in situ. The lower the number, the less the cancer has spread. For many people the stage is not determined until after surgery or the results of a PET Scan, so your doctor may wait until after they completed the operation or PET Scan to talk to you about the stage your are in. The more a cancer is spread, the lower the success rates seem to be, thus the higher the stage, the lower the success rate.
4. Is this an aggressive form of cancer?
This information will help you whether your cancer represents an urgency or an emergency. All cancers create an urgency, but not all cancers create an emergency. Knowing the time frame, you are facing can provide comfort for you.
5. Is there a specific cause to my cancer?
Gaining an answer to this question opens doors to possible treatments and prevention by eliminating the cause if possible from your life. Possible causes could be smoking, diet, environment, or genetics.
6. What do you propose as the treatment plan for my cancer?
There may be multiple treatment options for your cancer. Maybe there is a radiation option or a chemotherapy option. Perhaps surgery will be offered as an option for you, or perhaps all three will be included in your proposed treatment plan. The treatment plan that is best for you will depend on the stage or grade of your cancer, the chance that a type of treatment will cure the cancer or help in some way, your age, other health problems you may have, and your feelings about the treatment and the side effects that come with it. Regardless of what the proposed treatment method is, be sure to ask follow up questions.
7. What happens if the treatment plan doesn’t work?
When you are dealing with cancer, you need to know that there are no absolutes. There are no guarantees! It would be best if you are prepared for all contingencies. Knowing up front what those contingencies are, allows you to be better prepared
8. If chemotherapy is included in your treatment plan ask, what are the medications you intend to use in my treatments?
Each medication used in chemotherapy will have its own set of side effects and expected results. Depending on what the drug is supposed to do, will help you and your doctor determine the outcomes which occur — knowing what the medications will further build your knowledge base and help to prepare you for what is to come.
9. Question eight needs to be asked about every part of the suggested treatment plan. What are the short-term side effects?
Your doctor will tell you what the general short term side effects are, so write them down.
10. What are the longterm side effects?
Your Doctor will tell you what the general long-term side effects are, so write them down.
11. Will surgery be required and what kind of surgery will it be?
Any operation can have risks and side effects. Ask your doctor what you can expect and what your body will look like and how it will work after the surgery.
12. Will I need radiation?
Radiation uses high energy rays like x-rays to kill cancer cells. After surgery, radiation can kill small spots of cancer that may not be seen during the operation. If the size or place of the cancer makes surgery hard to do radiation may be used before the surgery to shrink the tumor. Radiation may also be used to ease some problems caused by the cancer. Radiation also carries side effects with it. The most common side effects are skin changes where the radiation is given, feeling sick to your stomach, diarrhea, blood in your stools, an increased need to urinate, burning when you urinate, blood in your urine, and feeling drained.
13. Now after you have discussed the general side effects ask your doctor: What have your other patients said about the side effects?
The answer to this question will help you understand the reality of what you have to face. It is one thing to say the side effects are these, but an entirely different thing to hear from people who have gone through it and how those side effects made them feel.
14. Are there things I can do to combat the side effects of my treatment?
It is evident that nothing is going to make the side effects go away, but there may be things that might help mitigate the severity of those side effects.
15. Side effects are one thing, and risks are a completely different thing, so ask: What are the risks associated with each of parts of your treatment plan are?
Make sure you know if the risks could be life threatening.
16. Should I change my diet?
There is no question that diet plays a significant role in your overall health, but you might find that most doctors gloss over the significance of changing your diet during treatment. If they do not put much credence in nuturitioin, you can ask if they could refer you to a dietitian and or a recommendation to a holistic physican that can be a part of your coordinated medical team.
17. Is this treatment plan Pallative or Curative?
Curative is intended to cure you. Palliative care has different objectives. One is to extend your life, and another is to improve the quality of your life for a while. It may sound harsh to state that you want to find out if your treatment is designed to extend your life a little longer. Remember knowledge is power and knowing the exact circumstances of your case allows you to explore what is best for you and your family.
18. Are there other treatments we could try?
You may have heard of other ways of treating your cancer or symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, diets, and other things. You may wonder about these treatments. Some of these are known to help, but others have not been tested. Some have been shown not to help, and others have even been shown to be harmful. Talk to your doctor about anything your thinking.
19. Is it possible my body can heal itself? If not why not?
The body is capable of marvelous things, and it is vital for you to understand what it can do and not do in your circumstances.
20. If I decide not to do everything you have suggested how will that affect my outcome?
It’s okay to ask your doctor what will happen if you choose not to do chemo, or radiation, or even surgery. Remember it is your life and it is your decision. What you are trying to do is develop a trust relationship with your doctor, and some of these questions may be hard to ask but as your doctor opens up and answers your questions you can decide if you want to trust them or seek a different one.
21. Have you had other patients who have had this diagnosis that you have treated? Moreover, what was the outcome for them?
Real life experience is invaluable for your journey. It won’t replace your own experience, but you can learn a lot from others.
22. If you or a member of your immediate family had this diagnosis would you recommend this treatment for them or would you take it yourself?
What you want to do with this question is to try and determine if your doctor is honest with you. Remember you want to build a level of trust between you and your doctor.
23. Do you participate in clinical trials and would you recommend them for me?
Clinical trials are research studies which test new drugs or other treatments. They compare standard treatments with others that may be better. If your doctor participates in these types of trials, you can go to www.cancer.org/clinicaltrials to find studies near you. Clinical trials are one way to get state-of-the-art cancer treatment. If your doctor can find one that’s studying the type of cancer you have, it is up to you to decide if you want to participate or not.