July 21, 2020

7 Key Questions to Ask Your Oncologist

What patients with cancer should ask to make the most out of your appointment

woman deep in thought

It can be hard to know what questions to ask your doctor after you’ve been diagnosed with cancer. All oncologists try to be as informative as they can, but it’s good to be proactive and ask as many questions as possible. Patients and families who advocate for themselves in positive, constructive ways get better care.

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After a cancer diagnosis, here are seven questions oncologist Suneel Kamath, MD, suggests patients ask:

1. Where and when do you recommend getting a second opinion?

Getting a second opinion is especially important when you’re first diagnosed to make sure your diagnosis is correct and so you’ll have a chance to explore all of your options. 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,” says Dr. Kamath. “Also, not every doctor can know everything about every condition. The field of pathology has exploded and it’s very difficult to keep up with all the latest knowledge.”

Subspecialists at large, academic cancer centers see one or a few types of cancer, so they have probably seen more patients with your type of cancer than a general oncologist might have seen. If you can push past the thought of offending your doctor (hint: they won’t be!), you will get peace of mind knowing that you were diagnosed correctly.

2. What can I do to preserve my fertility?

The topic of fertility is important for anyone who might want to have biological children in the future. If you don’t address it before the treatment begins, it can be too late. You might think fertility preservation could delay your treatment, but it doesn’t have to for many patients. In some cases, there’s just no time to think about fertility, but the question should be raised prior to cancer treatment.

Here are some questions you should ask your oncologist:

  • Will my cancer treatment affect my menstrual cycle?
  • After treatment, will I be able to successfully carry a pregnancy?
  • How long should I wait after treatment to try to become pregnant?
  • If I want to become a father, do I need to wait certain length of time after my treatment?
  • Is sperm banking going to be recommended or necessary at any point?

3. Is a clinical trial right for me?

There is a lot of misinformation about clinical trials. Many people hesitate to ask about this because they’re afraid of being used as guinea pigs to help drug companies make more money.

“In reality, patients who participate in clinical trials generally do better than those who do not,” says Dr. Kamath. “They’re getting tomorrow’s breakthrough therapy today.”

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Clinical trials exist to test for ways to prevent, treat and diagnose cancer while also managing symptoms and possible side effects. Clinical trials are available for every stage of cancer, too. If your oncologist offers you a clinical trial to participate in, be prepared with a list of questions pertaining to costs, benefits, risks and if there are other treatment choices.

“It’s important to know that no patients get placebos or sugar pills alone in oncology clinical trials,” says Dr. Kamath. “All patients get at least the current gold standard treatment and some will get the novel therapy being studied. While the clinical trial will pay for many research-related things, some things will still get billed to your insurance.”

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

If you’re struggling to cope with a cancer diagnosis, you’re not alone. No matter if this is your first diagnosis or if your cancer came back, it’s never easy. You may not know where to turn or who to ask for support.

Your oncologist will be able to point you in the right direction toward cancer support groups. 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 and it gets people through their fear of what’s coming.

5. What is the goal of my treatment?

The goal of your treatment is important to define upfront. It can range from long-term remission, to slowing its growth and prolonging life, to improving quality of life for your remaining days.

“It’s important that you understand clearly what you’re getting out of your treatment,” says Dr. Kamath. “You might not be willing to put up with six months of side effects if your disease is likely to come back within a year. However, you might tolerate a lot more side effects if your treatment can get rid of your cancer entirely and give you a long-term remission.”

6. What will my treatment cost?

Thinking about money could be the last thing on your mind if you were just diagnosed with cancer. Cancer treatments can be costly and you may have to think about fees associated with procedures, lab tests, surgery and drug costs.

“Many patients have a lot of out of pocket expenses, so it’s important to have a frank discussion about copays, facility fees and even parking,” says Dr. Kamath. “Those can really add up.”

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If the doctor doesn’t know the answer, ask to talk to a social worker or financial counselor. They may be able to find financial assistance programs or other resources.

“Financial side effects of cancer care are real and common,” says Dr. Kamath. “No one should feel ashamed or embarrassed to ask for help.”

7. What happens if there are no more treatments out there that can help me?

For some patients, their cancer will outsmart all existing treatments.

“That means you and your oncologist should have an honest discussion about your best option,” says Dr. Kamath. “This doesn’t mean giving up, it means changing your focus from treating the cancer at all costs to focusing on comfort and quality of life.”

While our culture doesn’t like talking about death, these are important discussions to have. Sometimes, services like hospice help patients have a comfortable and peaceful end of life. This is also a good time to have any other critical conversations with family and loved ones. So if your oncologist doesn’t bring it up, speak up. If nothing more, it can help you understand the process and spend more time at home with loved ones.

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