If your health care provider is not able or willing to answer these questions, you should think about finding another health care provider. Remember to bring a notebook to take notes on what your health care provider says. Having a tape recorder and another person to listen to what the health care provider says (and to provide emotional support) can be an enormous help.
Another helpful tool is to try visualizing what is being explained to you. Ask the doctor to show you an illustration to help you grasp where the cancer is, how tests will be performed, and how treatment will proceed. You can also use this illustration to help explain things to your family. Also, try to verbalize what you heard. Repeat to the doctor what you thought he or she said. This provides an opportunity to clear up any communication problems.
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Q: Is the doctor board certified? For the doctor’s education, training, certification, and years in practice, you can either ask the doctor directly, call his or her office, or call your local medical society or osteopathic medical association. You can also call your state board of medical examiners or look in the Directory of Medical Specialists (in public libraries). You can quickly find out if a doctor is board certified by calling 866-ASK-ABMS (275-2267) or going to the ABMS website and clicking on “Who’s Certified.” Verification is also available in the Official ABMS Directory of Board Certified Medical Specialties, published annually. The directory can be found in many medical and public libraries. Written verification is available by contacting the individual specialty board in the physician’s field of practice.
Q: What specialized training has the doctor had in treating the type of cancer you have? During the past 12 months, how many patients has the doctor treated with cancers similar to yours?
Q: When is the doctor normally in his or her office (days and hours of the day)?
Q: How can you reach the doctor during evenings and weekends?
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Q: What type of biopsy do you recommend?
- Incisional: Part of the tumor is cut out and examined under a microscope.
- Excisional: The tumor is removed totally.
- Needle: A needle is used to extract either fluid or tissue for microscopic analysis. This is also called “aspiration biopsy” and can usually be done as an outpatient with a local or minimal anesthetic.
Q: What is a sentinel node biopsy? Are you qualified to do it? Do you recommend it? Why or why not?
Q: What, specifically, did my biopsy show? Ask the doctor for a copy of your pathology report.
Q: If there is a malignancy, how much time can I take to make up my mind on what type of treatment to have?
Q: Are you recommending axillary node dissection for me? Why or why not?
Q: Has cancer spread beyond the original site?
Q: What stage is the cancer in? How was this determined?
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Q: Are there any specific instructions to follow before or after the test?
Q: How long will I be there? Will I be able to drive myself home?
Q: What are the risks in taking the tests? What are the most likely complications?
Q: Does my insurance company have to approve the test before it is done?
Q: Will the test hurt? How long before I can resume my usual activities?
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Q: What are my treatment options, considering the type and extent of my cancer, age, and lifestyle?
Q: What is the treatment’s goal?
Possible goals:
- Control growth of tumor
- Cure or eradicate the disease
- Increase comfort level (reduce pain, stimulate appetite, increase energy)
Q: Can you arrange for me to talk with someone who has been treated for this kind of cancer?
Q: What type of doctors will be involved in treating me? This team of doctors may consist of a medical oncologist, a surgeon, a radiation oncologist (sometimes referred to as a radiation therapist), and oncology nurses, social workers, pharmacists, dieticians, and rehabilitative specialists.
Q: Which treatments will provide me with the best chance of longterm survival and the highest quality of life?
Q: How do nonconventional treatments differ from standard medical treatments?
Q: How can I find out about nonconventional treatments?
For each treatment option:
Q: Please explain what the treatment is. (Consider getting an illustration from the doctor.)
Q: What are the short-term and long-term risks?
Q: What are the treatment side effects, and what can I do to lessen or prevent these? (medication, nutritional support, exercise)
Q: Do I need to restrict my diet or fluid intake?
Q: Will my treatment make me prone to infections? If so, what type of symptoms should I look for?
Q: What problems should I report to you?
Q: Will the treatment hurt or be uncomfortable? If so, how can I lessen or prevent this discomfort?
Q: How long will I be in this treatment (weeks or months)? And how often?
Q: If I take this treatment, what will my quality of life be like during and after treatment? How will it affect my ability to work or to perform other activities that are necessary and important to me?
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Q: Why do you believe surgery is necessary for me? Are there any nonsurgical alternatives?
Q: Is there a less invasive way to do this surgery?
Q: Please explain the surgery. Can you show me a diagram or illustration to help me to understand it better?
Q: Which surgery do you think is better for me, lumpectomy or mastectomy?
Q: What is lymphedema? How can I protect myself from it?
Q: What is reconstructive surgery? Can it be done in my case? Can you put me in touch with patients who have gone through it?
Q: How long does it take to resume normal activities after surgery?
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