As a naturopathic doctor with a dedicated clinical focus on cancer care, I understand the ramifications that a cancer diagnosis has on your life and the life of those around you. Aside from the physical, emotional and mental stress it places upon you, the overwhelming inundation of information and time sensitive decision making you have to face often spins a person into complete and utter disarray. When the time comes for you to sit down and make decisions on next steps, it’s absolutely critical to know the key questions to ask your oncologist before starting cancer treatment.
What does my diagnosis mean?
First and foremost, understanding the details of your cancer diagnosis is key. If, for example, you have been diagnosed with breast cancer, you need an explanation from your oncologist about what type of breast cancer you have, what stage, what does ‘your exact staging mean (is the cancer localized, has it spread, and if so where), and what both of these critical bits of information mean in terms of next steps.
Based on my diagnosis what are my next steps?
In terms of next steps, it’s important that your oncologist helps you understand and communicates all possible options. This means your oncology team should provide you with two key points of information: 1) testing and assessment plans (further imaging, blood work, biopsies, genetic tests, and applicable schedules and follows ups for each), and 2) treatment options (chemotherapy, radiation, surgery, other therapies, surveillance).
What are the specific details of my treatment?
Once all treatment options have been provided to you, it’s very important to ask specific questions about each treatment. If, for example, surgery is your doctors’ preferred choice, questions about success rates, side effects, recovery periods, and specific pros/cons will only help better inform you about that particular treatment. In addition, you also need to be informed about exactly what type of treatment (ie. surgery) would be performed. For example, if surgery is for localized breast cancer, will the surgery performed be a lumpectomy, quadrantectomy, modified radical mastectomy, or radical mastectomy, and then re-ask all above questions based on each. Lastly, it’s vital to ask about other options such as alternative treatments to the one being presented (ie chemotherapy options, active surveillance, radiation, clinical trials, immunotherapies etc.), and if chosen, what type of success rates come part and parcel of each.
Once I begin and complete my treatment(s), how will I be assessed and monitored?
This question is key as you want to know the exact expectations in terms of not only how the success of your treatment will be assessed, but based on those results, what options would then exist at that time. Questions such as secondary or additional treatments based on positive or negative results are important so that you are better prepared if or when the time comes. This being said, always keep in mind that manoeuvring cancer isn’t always predictable and transparent. There will be some instances where this question can’t be confidently answered, however speculation based on your oncologists experience should still be able to provide you with a somewhat detailed answer.
What if i decide to forego the recommended treatment option(s)?
Most doctors and oncologists prefer that patients adhere to their recommended treatment plans. Majority of the time, cancer treatment recommendations are in your best interest as the patient. That being said, it’s also worthy to clearly understand outcomes of choosing not to adhere to such treatments. When presenting your oncology team with this question, it’s important that a proper explanation is given in terms of actual percentage outcomes and realistic statements about all options and alternatives. This will also help you in terms of learning whether your oncologist is willing to work with you, regardless of your choice, as those who safely delay or chose against certain treatments (for various reasons) need to know if and how they will continue to be monitored as time goes on. This question also builds confidence (either way) about current or alternative treatment options.
Do I have the option to discuss and consider integrative cancer care?
Unfortunately, many oncologists have yet to fully understand or be properly educated on the benefits that integrative cancer care has with respect to better patient outcomes. Over 90% of people engage in some form of integrative or natural care. Choosing natural medicine over standard of care treatments is not usually the best option, however integrating both conventional and complimentary cancer care usually is. My medical experience in working with patients with cancer quickly taught me that if an oncologist is unwilling to at least listen to, or consider the medical evidence of integrative care, not only does this put the patient in a less than optimal position, it also reduces the potential of both short and long term treatment success and overall wellbeing of the patient.
Can you show me the evidence?
This is often an awkward question to pose to you oncologist, however it becomes relevant as it’s important for you to engage in the process of your treatment as well as ensure you are properly being heard. Oncologists may not always be able to respond with accurate scientific or clinical evidence on the spot, however it’s important that your doctors are willing to follow up with any questions, concerns or ideas that you have (other treatment options, adjunctive care, or simply a question for the sake of feeling better about what lays ahead). Ultimately, it’s crucial that you feel in control of, appreciated, and properly educated about your care.
As a naturopathic cancer care doctor at Cornerstone Naturopathic Inc., I’ve seen the good, bad, and the ugly when it comes to patients informing themselves about a cancer diagnosis. However, when a cancer diagnosis has been made, you need to feel as at ease as you can. Based on the power of knowledge, by asking these questions, it will better equip you to make more formidable and informed decisions about your care, and in more realistic time. Building a positive relationship with your oncology team is a must, as actively engaging in your disease and treatment journey can only help and should never hinder.
…Oh, and don’t forget, always ask for a copy of all medical reports for your files!