7 Key Questions to Ask Your Oncologist

A doctor’s advice on what cancer patients should ask

patient asking doctor questions

It can be hard to know what questions to ask when your doctor says you have cancer. Since oncologists often present “just the facts,” without necessarily opening up the floor for questions, it’s good to be proactive.

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After a cancer diagnosis, here are seven questions I suggest patients ask:

1. Where do you recommend getting a second opinion?

Patients are often afraid or intimidated to ask this because they do not want to offend their doctor. But it’s important for two reasons. It provides a second pathology review — especially crucial if you have been to a smaller hospital in the first place. Also, not every doctor can know everything about every condition. The field of pathology has exploded. It’s very difficult to keep up with all the latest knowledge.

2. What can I do to preserve my fertility?

This is important for younger people and, potentially, for older men. If you don’t address it before the treatment begins, it’s too late. In some cases, there’s just no time to manage this issue, and in others, it simply might not be possible to maintain fertility. But the question should be raised prior to therapy.

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3. Can I participate in a clinical trial?

Many people hesitate to ask about this because they’re afraid of being used as “guinea pigs” or otherwise nervous about things they have heard, but the reality of clinical trials generally doesn’t square with the myths. Patients who participate in clinical trials generally do better than those who do not. They’re getting state-of-the-art care.

4. What should I do if I’m simply having trouble coming to grips with my diagnosis?

Look for support. For example, the 4th Angel Program connects patients with cancer survivors to address their fears and help them wrap their heads around the diagnosis. Patients often appreciate talking with people who have been through it before. It gets people through their fear of what’s coming.

5. What is the goal of my treatment?

This is important to define up front, and it can range from defeating cancer entirely, to slowing its growth and prolonging life, to improving quality of life for the patient’s remaining days. The brighter the prognosis, the more side effects a patient should be willing to endure. It’s important that patients are clear on what they’re getting out of this. You might not be willing to put up with six months of side effects if your disease is likely to relapse within a year.

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6. What will my treatment cost?

Since patients pay more out of pocket, it’s important to have a frank discussion about co-pays, facility fees, even parking. Those can really mount up. If the doctor doesn’t know the answer, someone else should. And this ties back to question 5: If the goal is to make you feel better, and a cure is not possible, you’re much less willing to pay lots of money to get therapy. It’s not only physical side effects but financial side effects.

7. What’s the endgame?

If the goal of treatment is not cure — or if the cure isn’t achieved — you and your oncologist need to have a frank discussion about what can be accomplished. Physicians are notoriously bad about bringing this up. It’s easier to just roll out the next therapy than go through your options. As a result, many people get referred to a hospice later than they should, if at all. Our culture doesn’t like talking about death. But when you’re talking about cancer, it’s important.

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Matt Kalaycio, MD, FACP

Matt Kalaycio, MD, FACP, a U.S. News Top Doctor, is Director of the Department of Hematology and Medical Oncology at Cleveland Clinic.
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