Vital questions to ask your Doctor

Getting tested

1. What diagnostic tests or procedures are you recommending?
2. What extra information do you get from each of these tests?
3. Will the tests show whether I have cancer and whether it is benign or malignant?
4. Will they show what stage my cancer is at?
5. What does each of these tests involve?
6. How reliable are they?
7. What are the risks in undergoing these tests?
8. Do any of the tests have side effects?
9. What are the consequences if I do not have the test?
   
   If your doctor recommends a biopsy:
10. What type of biopsy do you recommend? Please explain it.
11. Who will perform the biopsy and where will it be done?
12. Will this biopsy cause neoplasm seeding?
13. Will I experience pain during or after the procedure?
14. Will the biopsy leave a scar and, if so, where will it be?
15. After the biopsy, if there is a malignancy, how much time can I take to make up my mind on what type of treatment to have?
16. If I undergo general anaesthesia, can you guarantee that you won’t go ahead with surgery other than a biopsy, if that’s my preference?
17. How long will it take to get the results of the biopsy?
    
    Getting Your Test Results
18. Did any of the tests or examinations indicate I have cancer?
19. If so, which one(s) and what did they show?
20. How reliable is this information?
21. What type of cancer do I have?
22. Where exactly is it located?
23. What is the stage of my cancer?
24. What grade is my cancer?
25. Do you know how quickly it is likely to grow?
26. Has the cancer spread (metastasised) to my lymph nodes or anywhere else?
27. Which lymph nodes might be affected by the cancer?
28. What are the implications of this?
29. What is my prognosis (chance of recovery)?
30. What are some common symptoms or side effects of this type of cancer?
31. How can I avoid these and/or manage them with my daily activities?
32. What can be done to minimise my symptoms or side effects?
33. Are there activities that may make them worse?
34. If new symptoms or side effects arise or existing ones worsen, what should I do?
35. Is this type of cancer caused by genetic factors?
36. Are other members of my family at risk?
    
    Add any additional questions you may have.

* Neoplasm Seeding
The unintentional release of cancer cells from a tumor by a biopsy needle or surgical instrument, which then spread to other parts of the body resulting in new tumor formation.

Getting your test results
Your doctor should make time to answer your questions and explain the treatment options.
If possible, bring a spouse, friend, or relative with you. They can take notes from your conversation with the doctor.

Second Opinion
Consider seeking a second opinion about your diagnosis or proposed treatment plan. This may help you feel more confident about your choices.
Most doctors fully understand the value of a second opinion and are not offended when patients seek one.
They may even be able to suggest another doctor.

Proposed Treatment Plan

Some of the most important questions to ask:

1. Which treatments are you recommending for me?
2. What is the goal – to cure the disease, control its spread, or relieve symptoms?
3. What is the absolute survival benefit of this treatment, not just the relative benefit? *
4. Which reliable studies verify this treatment will prolong my life (not just shrink a tumor) when directly compared to no treatment at all?
5. Will this treatment kill my cancer stem cells? **
6. Besides treating cancer, what will you do to treat my symptoms?
7. Are there biomarkers that could guide treatment choice?
8. What results would you expect to see with this treatment?
9. Is there a maximum planned duration, or will therapy continue indefinitely?
10. What happens if treatment produces a complete response?
11. What happens if the cancer progresses immediately?
12. How likely is this treatment to cause secondary cancers?
13. What are the most serious risks to my organs, nerves, heart, kidneys, liver, or immune system?
14. What is the absolute risk that this cancer will come back?
15. What will happen if I choose not to have this treatment?
16. Is there an alternative therapy that has proven effective in treating my type of cancer?
17. What would be the “down-side” of trying an alternative therapy before starting standard treatment? Prove it to me.
    
    Add any additional questions you may have.

See Fertility Concerns at the bottom of this page

* Important distinction
Patients are often told that a treatment “reduces risk by 30%” or “improves survival.” Those phrases are inadequate without context. For example, reducing recurrence from 21% to 14% is a 30% relative reduction, but only a 6-percentage-point absolute reduction. Both figures are mathematically correct, yet they can create very different impressions.

** Cancer stem cells are a small group of cells inside a tumor that can self-renew, drive tumor growth, and resist treatment. They act like the “root” of a weed, making it possible for cancers to grow back or spread even after standard therapy.

Remember
You are the most important member of your health-care team. Your situation is unique, and your treatment should be developed just for you.

Surgery

1. Why are you recommending Surgery?
2. What is the goal of this treatment?
3. What proof is there that this treatment will bring meaningful benefit?
4. What risks or complications are associated with this treatment?
5. What would you consider to be a successful treatment outcome (e.g. no tumour remaining, a reduction in tumour size or another outcome? 
6. What is the success rate for this treatment? 
7. Will this treatment kill my cancer stem cells? *
8. What is the risk of death or serious harm?
9. Do you feel the benefits outweigh the risks? Why?
10. Will this be the only treatment modality I need? 
11. Will this treatment increase the risk of the cancer spreading?
12. What are the possible consequences of postponing the surgery?
13. What will happen if I don’t have this treatment?
14. Are there any less extensive, less deforming, less painful operations than the one you are suggesting? If yes, what are they?
15. What are the risks and benefits of the other possible treatments?
16. Where can I find out more about these alternatives?
    
    SURGERY RESULTS
17. How big is the tumour?
18. Were you able to remove it entirely?
19. What stage is the cancer?
20. What does that mean?
21. How many lymph nodes were removed (if any)?
22. Did any of them show cancer?
23. Has the cancer spread anywhere else?
24. What is the grade of the cancer?
25. How fast is it growing?
26. What are the chances that the cancer will come back?
27. When will I know if the treatment was successful? 
28. What happens if there is no response? 
29. How common is that and what is the fall-back plan? 
30. What are the possible long-term effects? 
31. How are they usually managed? 
32. What are the chances of the cancer returning? 
33. What follow-up tests do I need, and how often will I need them? 

See Fertility Concerns at the bottom of this page

* Cancer stem cells are a small group of cells inside a tumor that can self-renew, drive tumor growth, and resist treatment. They act like the “root” of a weed, making it possible for cancers to grow back or spread even after standard therapy.

Remember
You are the most important member of your healthcare team. Your situation is unique, and your treatment should be developed just for you.

Chemotherapy

1. Why are you recommending I have Chemotherapy? 
2. What is the goal of the treatment? 
3. What proof is there that this treatment will bring meaningful benefit?
4. What is the success rate for this treatment? 
5. What risks are associated with this treatment?
6. What would you consider to be a successful treatment outcome (e.g. no tumour remaining, a reduction in tumour size or another outcome? 
7. Will this treatment kill my cancer stem cells? *
8. What are the potential side-effects?
9. What is the risk of death or serious harm?
10. Do you feel the benefits outweigh the risks? Why?
11. Will this be the only treatment modality I need? 
12. Will this treatment increase the risk of the cancer spreading?
13. What are the possible consequences of postponing treatment?
14. What will happen if I don’t have this treatment?
15. Are there any conventional treatment alternatives to chemotherapy?
16. Where can I find out more about these alternatives?
17. What type of chemotherapy will I be on? 
18. Will the chemotherapy make me prone to infections? 
19. Will I be offered a Chemo-sensitivity Test? **
20. If so, where will this test be conducted, and when will the results be available? 
21. Is Chrono-therapy available to me? ***
22. Is there an alternative therapy that has proven effective in treating my type of cancer? 
23. What would be the “down-side” of trying an alternative therapy before starting any Chemotherapy? 
24. What are the likely consequences if I don’t have this treatment? 
    
    Treatment phase
25. What are the possible side effects? 
26. When are they likely to start? 
27. How are they usually managed? 
28. Are there any side effects I should report right away? 
29. What symptoms – swelling, fever, nausea and so on – might be a sign of a problem? 
30. Is there anything I can do myself to lessen the side effects? 
31. Can the cancer spread, even though I am on Chemotherapy? 
32. Will I be nauseous? 
33. Will I be exhausted?
34. What type of activities should I avoid while on this treatment? For how long? 
35. What will you do to reduce my risk of chemo-induced cachexia?
    
    Long Term 
36. What are the possible long-term effects? 
37. How are they usually managed? 
38. Are there any special exercises I can do to help my recovery? 
39. Are there any special instructions to follow after the treatment is finished? 
40. When will I know if the Chemotherapy has been successful? 
41. What are the chances of the cancer returning? 
42. What happens if there is no response? 
43. How common is that and what is the fall-back plan? 
44. What follow-up tests do I need, and how often will I need them? 

Add any other questions you may have. 

See Fertility Concerns at the bottom of this page

* Cancer stem cells are a small group of cells inside a tumor that can self-renew, drive tumor growth, and resist treatment. They act like the “root” of a weed, making it possible for cancers to grow back or spread even after standard therapy.

** Chemosensitivity Tests 
Personalized cytometric profiling reveals which anti-cancer drugs are effective at killing each patient’s cancer cells and which agents are not effective. The most promising drug regimen can be selected for each cancer patient, increasing the odds for treatment success. At the same time, ineffective drugs are avoided. This spares the patient needless exposure to harmful side effects from drugs that can’t possibly help them. Further, valuable treatment time is not wasted, and the patient does not incur unnecessary costs from expensive but ineffective treatments. For a list of Laboratories that supply these tests, please see Chemosensitivity Tests 

*** Chronotherapy 
The administration of Chemotherapy doses synchronized to the body’s circadian rhythm may raise allowable doses of chemotherapeutics and lower tumor burden and chemotherapy-related side effects. You are the most important member of your healthcare team. Your situation is unique, and your treatment should be developed just for you.

Remember
You are the most important member of your healthcare team. Your situation is unique, and your treatment should be developed just for you.

Radiation treatment 

1. Why are you recommending radiation treatment?
2. What is the goal of this treatment? 
3. What proof is there that this treatment will bring meaningful benefit?
4. What is the success rate for this procedure?
5. What risks are associated with this treatment?
6. What would you consider to be a successful treatment outcome (e.g. no tumour remaining, a reduction in tumour size or another outcome? 
7. Will this treatment kill my cancer stem cells? *
8. What is the risk of death or serious harm?
9. Do you feel the benefits outweigh the risks? Why? 
10. Will this be the only treatment modality I need? 
11. What other organs and tissues will receive radiation as well as the target area? 
12. Will the beam be modulated in any way to minimise damage? 
13. What are the chances of it causing long-term damage to surrounding organs and/or bones? 
14. Will this treatment increase the risk of the cancer spreading?
15. What are the possible consequences of postponing the treatment?
16. What is likely to happen if I don’t have this treatment? 
17. When will I know if the treatment was successful? 
18. What happens if there is no response? 
19. How common is that and what is the fall-back plan? 
20. What are the possible long-term effects? 
21. How are they usually managed? 
22. What are the chances of the cancer returning? 
23. What follow-up tests do I need, and how often will I need them? 

Add any other questions you may have. 

See Fertility Concerns at the bottom of this page

* Cancer stem cells are a small group of cells inside a tumor that can self-renew, drive tumor growth, and resist treatment. They act like the “root” of a weed, making it possible for cancers to grow back or spread even after standard therapy.

Remember
You are the most important member of your healthcare team. Your situation is unique, and your treatment should be developed just for you.

Other conventional treatments

1. Why are you recommending I have this treatment? 
2. What is the goal of the treatment? 
3. What proof is there that this treatment will bring meaningful benefit?
4. What is the success rate for this treatment? 
5. What risks are associated with this treatment?
6. What would you consider to be a successful treatment outcome (e.g. no tumour remaining, a reduction in tumour size or another outcome? 
7. Will this treatment kill my cancer stem cells? *
8. What are the potential side-effects?
9. What is the risk of death or serious harm?
10. Do you feel the benefits outweigh the risks? Why?
11. Will this be the only treatment modality I need? 
12. Will this treatment increase the risk of the cancer spreading?
13. What are the possible consequences of postponing treatment?
14. What will happen if I don’t have this treatment?
15. Are there any conventional treatment alternatives?
16. Where can I find out more about these alternatives?
17. What type of drugs will I be on? 
18. Will the treatment make me prone to infections? 
19. Is there an alternative therapy that has proven effective in treating my type of cancer? 
20. What would be the “down-side” of trying an alternative therapy before starting any conventional treatment? 
21. What are the likely consequences if I don’t have this treatment? 
    
    Treatment phase
22. What are the possible side effects? 
23. When are they likely to start? 
24. How are they usually managed? 
25. Are there any side effects I should report right away? 
26. What symptoms – swelling, fever, nausea and so on – might be a sign of a problem? 
27. Is there anything I can do myself to lessen the side effects? 
28. Can the cancer spread, even while I’m in treatment? 
29. Will I be nauseous? 
30. Will I be exhausted?
31. What type of activities should I avoid while on this treatment? For how long? 
    
    Long Term 
32. What are the possible long-term effects? 
33. How are they usually managed? 
34. Are there any special exercises I can do to help my recovery? 
35. Are there any special instructions to follow when the treatment is finished? 
36. When will I know if the treatment has been successful? 
37. What are the chances of the cancer returning? 
38. What happens if there is no response? 
39. How common is that and what is the fall-back plan? 
40. What follow-up tests do I need, and how often will I need them? 

See Fertility Concerns at the bottom of this page

* Cancer stem cells are a small group of cells inside a tumor that can self-renew, drive tumor growth, and resist treatment. They act like the “root” of a weed, making it possible for cancers to grow back or spread even after standard therapy.

Remember
You are the most important member of your healthcare team. Your situation is unique, and your treatment should be developed just for you.

Using Alternative Treatments

Alternative cancer treatments are generally used in place of Conventional treatments such as chemo and radiation. Many of them are available in private cancer clinics only.

1. Why am I considering the use of this treatment?
2. What do I hope the treatment will accomplish?
3. What are the advantages of using this treatment instead of standard treatment?
4. What are the disadvantages of using this treatment instead of standard treatment?
5. Will I be able to speak to other patients who have used this treatment successfully?
6. Have others with my cancer type used this treatment successfully?
7. Are there any Clinical Trials, Scientific Studies, or Reviews to show the efficacy of this treatment for my cancer type?
8. Does this treatment offer me a better chance of overall survival than standard treatment?
9. What are the likely consequences if I don’t have this treatment?
10. Is there a Cancer Coach or Alternative Practitioner I can consult for once-off or ongoing advice?
11. Will my doctor continue to care for me if she/he knows about my use of this treatment?
12. Will my family support my choice of treatment?
13. Will my doctor address any concerns my family may have in advance of treatment?
    
    Undergoing treatment
14. Will I need to go to a hospital, clinic or retreat to have this treatment?
15. If yes, how long will I have to spend there?
16. How will the treatment be given?
17. Who will give it to me?
18. How often will it be given?
19. Over what period of time?
20. How long will each treatment take?
21. What parts of my body will be targeted?
22. What (if anything) will this treatment do that could harm my body?
23. Will I feel pain or discomfort during the treatment? 
24. Can I go home immediately afterwards?
25. Are there any side effects associated with this treatment?
26. If so, what are they?
27. How will they be treated?
28. Should I change my diet or take any vitamins, minerals or other supplements?
29. Will drugs be used in this treatment?
30. What are the names of the drugs?
31. Why are these drugs used?
32. How many drugs will I be taking at one time?
33. Will the drugs make me prone to infections?
34. Will treatment affect my usual activities? If so, for how long?
35. Will I need to take time off work or adjust my work schedule?
36. Will I need help with daily activities during treatment?
37. When I am having treatment, can I eat all kinds of foods?
38. Can I drink alcohol?
39. Can I take other medications at the same time?
40. Are there any special precautions I need to take while undergoing treatment?
41. Are there special instructions to follow while I’m undergoing treatment or after the treatment is finished?
    
    Treatment phase
42. Will I have pain or discomfort during or after treatment?
43. How long will it last?
44. How can it be managed?
45. What are the possible side effects?
46. When would they start?
47. How are they usually managed?
48. Are there any side effects I should report right away?
49. Who do I call?
50. What symptoms – swelling, fever, nausea and so on – might be a sign of a problem?
51. Is there anything I can do to lessen the side effects?
52. Can the cancer spread, despite undergoing this treatment?
53. Will I gain or lose weight?
54. What type of activities should I avoid while on this treatment? For how long?
    
    Long Term
55. Are there any possible long-term effects?
56. How are they usually managed?
57. Are there any special exercises I can do to help my recovery?
58. Will I need physiotherapy?
59. Are there any special instructions to follow after the treatment is finished?
60. How long will it take for the treated area to heal?
61. When will I know if the treatment is proving successful?
62. Are there tests I can use to check progress?
63. If so, what are they?
64. How can I access them?
65. What are the chances of the cancer returning?
66. What follow-up tests do I need, and how often will I need them?
67. Will I still have access to Tests, Scans, X-Rays etc in my local hospital if required?
68. Will I be able to change to a different treatment option if this doesn’t work?