15 Things Your Oncologist Wants You to Know
- What's an Oncologist?If you are living with cancer, an oncologist has cared for you at some point. This is a cancer specialist who helps diagnose and treat the disease. Three types of oncologists may be involved in your treatment. A medical oncologist works to eliminate your cancer using drugs; surgical oncologists operate on your body to remove tumors; and radiation oncologists use radiotherapy to target and destroy cancer cells. Your partnership with these doctors is a key part of your treatment journey. Talking to them openly and honestly helps you get the best possible treatment. Here’s what oncologists want their patients to know about facing cancer together.
- 1. "Most cancers are random.""So many patients with cancer ask 'Why did I get this?' or want to blame their behaviors or environment," says Elizabeth R. Plimack, MD, an associate professor in the department of hematology/oncology at Fox Chase Cancer Center in Philadelphia. "But it's usually not your fault or anything you did. Even though cancer can be genetic and caused by smoking and viruses, most cancers are random."
- 2. "Cancer treatment is a lot different than a decade ago."Don't go into your appointment with any preconceived notions about treatment or its side effects, like vomiting or compromised immunity. "Your experience will be so different than that of your friends or family who were treated 10 to 15 years ago," Dr. Plimack says. "We give chemotherapy so much more easily now that we have good anti-nausea drugs and good medicines to boost the immune system."
- 3. "Always bring a second set of ears with you."Bring a family member or a close friend with you to all your appointments, starting with the first one. It's especially important to bring this person to any visits that involve reviewing scans or test results. "You're probably only going to catch about 30% of the information that the doctor or team tells you," says Philippe E. Spiess, MD, a genitourinary oncologist at Moffitt Cancer Center in Tampa, Fla. The more people you can bring to the key visits the better, adds Dr. Plimack, who says this makes it easier for the whole family to hear any tough news straight from the doctor.
- 4. "Carry a notebook."Gather your questions ahead of time and come in with a pen and paper. "Often times people come into my clinic and they feel nervous, they feel rushed, and they forget things," says Dale R. Shepard, MD, a director at Cleveland Clinic Cancer Center. "It is much easier to create a checklist ahead of time than to call with each question as you think of it." Use the notebook as a diary to track things like symptoms or concerns. Bring it with you to each doctor's appointment. The person who came with you to your appointment can also use it to take any notes during your checkup.
- 5. "Ask: 'Is it curable or controllable?'"Curable means you will have some type of treatment and are expected to be cancer-free when it is completed. Controllable means the cancer does not go away but doctors will try to manage symptoms and make you live longer. "Sometimes the doctor doesn't know right away which it is," says Dr. Plimack. "But ultimately a doctor should be able to tell you and estimate the chances of cure for you." If the cancer isn't curable, ask your doctor about your treatment expectations and work together to establish goals.
- 6. "Let me know your wishes."Cancer treatment can have different side effects and results. Tell your doctor about your future hopes and dreams. For example, a 75–year-old patient may not have the same wishes as a young mom hoping to see her child graduate. "We can do our best to help make sure we get you to the point you want, but we have to understand what is important to you to really help," explains Dr. Plimack. Don't limit your outlook to an event. Talk about aspects of your current physical health, like your sex life, which can be affected by some cancer therapies. If your doctor knows what is important to you, there may be ways to help.
- 7. "We'll tailor treatment to you and your beliefs."Make sure your doctor also knows about any religious preferences or customs that are important to you or that may influence your care. "We can devise a treatment plan that is right for you and your expectations and is respectful of your culture beliefs and ethnicity," says Spiess.
- 8. "Be comfortable with your treatment plan."Cancer diagnosis is a life-changing event. There's always a sense of urgency. But you want to make sure you're doing the right thing. "Take time to ensure the treatment plan makes sense," says Dr. Shepard. "You don't want to race into surgery when really that might not have been the right idea." He also suggests looking at treatment locations. For example, do you want to go to a large academic center a bit farther away or be treated locally close to home?
- 9. "Never, ever hesitate to get a second opinion."It's sometimes important to get another perspective about your treatment plan. Your doctor should encourage this. "If a patient seeks one, I don't take it as questioning my treatment," says Dr. Spiess. Dr. Shepard agrees: "You can set a treatment path but if you're on the wrong one, you're not doing the patient any good. You have to be sure from the beginning you're moving in the right direction."
- 10. "Ask: 'What does success look like?'"You will have lots of imaging tests to see how well your cancer treatment is working. Ask your doctor what you should expect from your tests. How exactly do they measure success? Is the tumor going to disappear? Shrink? By how much? "If patients know from the beginning what doctors are expecting to see, then they're ok with that," says Dr. Shepard. "If they don't have that perspective, they might ask, 'You mean it's still there?'" if the cancer is still seen on the scan after treatment.
- 11. "Be honest with me."A little white lie can be bad for your health, especially when it comes to things like supplements." People have the mistaken notion that I'm anti-anything that I'm not prescribing," Dr. Shepard says. "I might not know specifically if a supplement is going to help or be harmful but it might have an impact on the chemotherapy so you have less benefit." Also, don't be afraid to tell your doctor about any symptoms. Some patients don't because they fear the doctor will change their chemotherapy drugs and start treatment over. "But if I know about it, it's likely I can do something to make your symptoms better," he adds.
- 12. "If you wonder if you should call, you should call."Cancer can be confusing and stressful for you and your family. Doctors want you to call if you have any questions. You aren't being a burden. Doctors are there to help you. "If it's worrisome or concerning to you, it's important to us," Dr. Shepard says. "Accessibility for cancer patients is enormously important. Whenever you have a question, call. I want you to call." Remember, there no such thing as a stupid question.
- 13. "Tell people about your cancer."Let your family and friends know about your cancer diagnosis and your treatment. "There are too many people that try to keep their diagnosis a secret," says Dr. Shepard. "Friends and family are an invaluable source of emotional source and transportation support. They are there to help. If they offer to help, let them help."
- 14. "Be prepared for unsolicited advice.""It will happen. You just need to be prepared for it," says Dr. Shepard. "You'll be in the grocery store. People will come up and give you advice on how you should be managing your cancer. They'll talk about foods and alternative therapies." He suggests being patient and taking away the good information. Don't second guess right away, and be open to discussing any ideas with your doctor. "At least, talk to us about it," he says.
- 15. "Share your journey with other patients.""Cancer is not necessarily like any other diagnosis. There are a lot of life-threatening fears and a lot of challenges," says Dr. Spiess. Most cancer centers or clinics have counselors or psychotherapists who can help guide you during this time. Some patients find support groups to be helpful. Ask your doctor or nurse if they can recommend how to find one in your area. "I think it's important for patients to feel like they have a reference from another patient's standpoint so they can share what their journey has been like and what they have gone through."
15 Things Your Oncologist Wants You to Know