Five Questions to Ask at Your First Cancer Appointment
Hearing the words “you have cancer” from your doctor can be a difficult experience. All of our physicians at the UW Carbone Cancer Center know how hard it can be for patients – and they know how important it is for each patient to receive the treatment that makes the most sense for him or her.
“I view each patient who comes in my door as a person I am establishing a relationship with, and those relationships work best as a two-way street,” says Chris Fletcher, MD, a hematologist at UW Carbone who specializes in treating lymphoma patients. “I get more worried when patients don’t ask many questions, because asking questions helps me understand someone better. Ultimately, when a patient asks me for a recommendation, they’re not necessarily asking me what I’d choose for myself, they’re asking me what’s right for them.”
Most cancer patients will meet with their doctor several times during treatment, so Fletcher recommends focusing on the following five questions during that first appointment, which he explains below. These questions are part of Cancer Clear & Simple, a curriculum and topical handouts developed by UW Carbone’s Cancer Health Disparities Initiative’s (you can download and print a form with the five questions at CHDI’s website, here).
“It’s important to emphasize that these questions help improve your relationship with your doctor, and they improve your ability as a patient to know what is right for you,” Fletcher says. “Importantly, we recommend these questions for your first appointment, but patients are certainly not limited to these five. Also, we encourage you to write down questions as you have them and bring them to your next appointment, or to call the clinic between visits.”
Five Questions to Ask When You've Been Diagnosed with Cancer
What kind of cancer do I have? Where is the cancer? Has it spread?
These are questions that really get to the heart of the matter regarding a person’s prognosis. Doctors use this information to make decisions on what treatments can be used (for example, we generally do not recommend surgery for cancers that have spread throughout the body). This information also helps doctors predict whether the cancer could cause symptoms or affect health in other ways. These are important questions for patients to ask because the answers help to provide the information that people need to make their short- and long-term life choices.
Can my cancer be treated? What are my treatment options?
Treatable really means that there are medical interventions available to you that will change some aspect of what the cancer is doing in your life right now. Generally, the goal of most cancer treatments is to prolong life by some amount. However, symptom management is often equally important. If a treatment will improve a patient’s symptoms, then it makes sense to consider that treatment in our approach. If a cancer is treatable but treatment comes with a lot of side effects, then it paints the treatment approach in a different light. I think it is also important to emphasize here that treatable and curable do not mean the same things. If there is a treatment for your cancer, it does not always mean your cancer is going to go away permanently (which is what it means to be cured). Some cancers are actually chronic diseases that people can live with for a long time as long as the cancer can be controlled. Unfortunately, some cancers are both not curable and life-threatening when they are in later stages, in which case symptom management is very important.
What can I expect during treatment?
This question asks not just what the treatment is and what side effects to expect, but also, what will my life be like while I am on cancer treatment? For example, how many days of work might I miss, or will I be able to work at all during treatment? That information is not always something a cancer doctor says to a patient specifically, and I do try to weave it into the conversation. At first, when discussing more than one treatment option with a patient, I try to compare the options with this broader view. Once these basic ideas are understood, I will get into details about specific side effects.
How much time do I have to think about my options or get a second opinion?
This is a fantastic question. If it is not asked, I think some patients get the idea that treatment has to start tomorrow, and that is often not the case. Or quite the opposite, some patients want to put off starting treatment for as long as possible, but putting it off may prevent them from having a particular option – or worse yet, may change the odds of success. I find many patients are worried their doctor will be upset with them if they ask for a second opinion, but that is not the case – we encourage it! Also, I can often point a patient to a second institution with an expert in their disease much more easily than a patient can find one on the internet.
What local resources are there to help me cope with my diagnosis?
Cancer can be a burden in many ways – emotionally, physically, financially… It really and truly does take a community to get an individual through cancer treatments. Many patients seek the support of other people who have been through a similar type of experience with cancer.
I think you can never go wrong with reaching out to local groups like Gilda’s Club, the American Cancer Society, or a specific disease society such as the Leukemia and Lymphoma Society. Our social workers at the Carbone Cancer Center are the people who know the most about hospital and community resources, and patients are encouraged to ask to speak with them.
Note: CHDI also has many other useful documents with questions to ask your doctor, such as questions to ask after treatment has been completed, or cancer type-specific questions. Click this link and scroll down to “Questions to ask your doctor” for more.
Date Published: 10/09/2018