One of the first physicians you may speak with after a cancer diagnosis is a medical oncologist.
These doctors specialize in treatment with medications, such as chemotherapy, targeted therapy or immunotherapy. (Surgical oncologists, meanwhile, treat cancer by performing surgical procedures, and radiation oncologists use proton therapy, brachytherapy, and other types of radiation therapy to treat it.)
So, what should you ask your physician to get the most out of your first visit? We spoke with Eric Singhi, M.D., a medical oncologist who treats thoracic cancers at our Texas Medical Center Campusand MD Anderson West Houston. Here are the top five questions he recommends asking your medical oncologist during your first appointment.
1.What type of cancer do I have?
The answer to this question may seem obvious, but it’s not. Or, at least, not always. That’s because many cancers don’t start causing problems until they’ve metastasized — or spread — to other areas of the body.
Lung cancer, for instance, may only come to your attention because it’s affecting the nerve that controls your vocal cords. A malignant growth near the end of your large intestine, meanwhile, is most likely one of three diseases that tends to develop there: anal cancer, rectal cancer or colon cancer. And, what appears at first glance to be salivary gland cancer may turn out to be a skin cancer that started on your scalp.
“Don’t assume you know what type of cancer something is based solely on its current location,” says Singhi. “Ask your doctor for an exact diagnosis.”
2.Where is the cancer in my body?
Cancers are grouped based on their place of origin. Once you know the specific type of cancer you have, the next step is to determine its stage. The stage indicates how far the cancer has spread, including its location, size and whether it has grown into nearby tissues, lymph nodes or other parts of the body.
Early-stage cancers that form solid tumors are generally confined to the same places they started, and typically involve surgery, although radiation and chemotherapy treatments may also be used. But later-stage cancers, by definition, have already spread beyond their original locations. So, they may involve both larger tumors and other organs or tissues, making their treatment more complex.
This is different from blood and bone marrow-based cancers such as leukemia and lymphoma, which are often first detected through abnormalities in lab tests rather than the presence of lumps or abnormal growths.
“It’s important to clarify just how advanced your cancer is and all of the places it’s located,” Singhi notes. “Accurate staging determines which treatments you’ll be offered and why. And, sometimes, even a slight difference in staging can make a big difference in the treatment recommended.”
Your care team will use a combination of physical exams, body scans and lab tests to find out the full extent of the disease.
3.What are my cancer treatment goals?
This is probably the most important question to ask. Knowing your treatment goals can affect both how you feel during treatment and when — or if — it ends.
“With early-stage cancers, the goal of treatment is usually removing all evidence of disease,” says Singhi. “But it could be more nuanced. With later-stage cancers, for instance, the goal might be to prolong someone’s life by slowing the cancer’s growth or to reduce and manage their symptoms.”
Sharing your goals for treatment and what matters most to you with your care team is extremely helpful. For some people, living long enough to mark a particular milestone may be a priority. For others, maintaining a high quality of life in the time they have left is what matters most.
“Whatever is most important to you and what you hope to achieve with treatment, we want to know about it,” Singhi says. “The things you find meaningful are a significant part of the equation to us. We’re partners in your care.”
4.Who else is on my cancer care team?
MD Anderson’s team approach to care means you have many experts in your corner, including, but not limited to: physicians, advanced practice providers, registered nurses, patient access staff, patient service coordinators, case managers, dietitians, occupational or physical therapists, pharmacists and social work counselors.
Knowing who to talk to when questions arise is a vital aspect of good cancer care. So, take time to find out exactly who your providers will be and how to reach them quickly if you need to.
Most cancer patients’ care teams will also involve a combination of oncologists:
- a medical oncologist
- a surgical oncologist and/or
- a radiation oncologist.
If you’re diabetic, you may need an endocrinologist, too. Or, if you have heart problems, you may need an onco-cardiologist. Clinical trial participants may also have a research nurse assigned to them.
Regardless of how many specialists are involved in your care at MD Anderson, though, they will all work together to give you the best possible experience during your cancer treatment.
“Solid communication is what keeps things running smoothly,” says Singhi.
5.What are the next steps for my cancer treatment?
Once you’ve established the basics of your diagnosis, it’s time to start looking ahead. So, what needs to happen next?
Here are some questions to consider asking during your care:
- Will I need any additional tests before you can start treatment?
- What are my treatment options?
- Do I need to schedule surgery or set up regular appointments for chemotherapy infusions?
- If I need radiation therapy, how many days a week will it be, for how many weeks, and how long will each treatment last?
- Can my treatments be scheduled around my job or other obligations?
- What kind of side effects can I expect, and what can be done to decrease their impact?
- How will treatment or surgery affect my daily activities, like the ability to work, exercise and have sex?
- What other lifestyle changes can I expect?
- If I need surgery, how long will it take me to recover after the procedure? How long will I stay in the hospital? What should I be looking for in case there is any complication after surgery?
- Who can I contact if I have a question and what’s the best method of reaching them?
“Asking all of these questions can help you determine where and how you’re going to be spending your time receiving cancer care over the next few weeks or months, so you can start working out logistics and making concrete plans,” says Singhi.
If you need a certain number of chemotherapy infusions, for instance, ask if they can be handled on an outpatient basis, or if you’ll need to be hospitalized for each one. Make sure you’re getting information from your insurance provider, too, and find out what pre-authorizations will be needed. Find out how long it might take for you to recover from surgery, and if the clinic location closest to your home or job can provide any of the other services you might need.
“A cancer diagnosis can be really overwhelming,” notes Singhi. “So, having the right tools to start the conversation is critical. And getting the answers to these — and any other questions you might have — will help you stay better informed and more empowered in your cancer care.”
Review new patient information and resources at MDAnderson.org/FirstVisit. Check out the First Visit Guide to learn what to expect during your first appointment with us, learn about members of the care team and review questions to ask during your first appointments.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.
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