Glossary of Terms

Conventional Medical Care

Holistic Care

Environmental Issues

Early Detection/Screening

Rachel's Corner

Reading List

Links

For your information

Being proactive with your medical provider at the start will set the stage for a thoughtful and respectful relationship with you throughout your treatment process. A primary way to achieve this relationship is to ask questions at the start. Here are some ideas for doing so:

1. Take time to gather information to make carefully considered decisions. Ask for information in small doses, so you can absorb it. Ask for a time in which you can meet with the doctor along with a friend, spouse, partner or relative to help you ask questions and take notes or tape-record the discussion. If you would like to get a second opinion, say so and ask for a referral.
2. Convert fear into facts. You have an obligation to yourself and your future to be active in gathering information about your own health. Most likely, you will face some big decisions, and will need to become familiar with medical terminology and procedures for treatment. If you don't understand the answer, say so. Be assertive. Use words like: "You're going too fast." "I feel like I'm not being heard." "I'm on overload right now. Can you help me understand this better?"
3. Ask about fees when meeting with any member of your medical specialists' team. Will their services be covered by your existing insurance?
4. For an understanding of cancer terminology, tests and procedures, see the glossary in the appendix of this notebook.
5. Use free, informative literature from cancer organizations. See the resources section in the appendix of this notebook.

Questions to ask ... at or soon after diagnosis

To help you, here are general questions to ask the doctor who initially talks to you about your diagnosis (see the glossary in the appendix for definitions).

1. What kind of cancer is it?
2. What stage is it in? Is there any indication that it has spread to other areas, or is it localized? How was this determined?
3. Are there any additional tests recommended to determine if and where it has spread? Are there any risks to these tests?
4. How aggressive is it? How was this determined?
5. What are all my treatment options? Which option or options do you recommend and why? You may want to seek a second opinion and do your own research.
6. Are there medication choices available? What are the complications, pros and cons, of each medication option? Will I become addicted to any of the medicines?
7. Given my specific type of cancer, its stage and its aggressiveness, what are typical survival rates?
8. What can I do to improve the likelihood of long-term survival? Are there any complementary therapies that could be useful? (Some traditional medical centers have added complementary therapies, such as meditation, visualization, nutritional support and acupuncture or acupressure, to their services.)

1. What grade are the cancer cells? Cancer cells are evaluated as to the degree of aggressiveness in their ability to spread. Grade 1 cells are well differentiated, which means they resemble the tissue of origin. Grade 4 are undifferentiated, which means they grow more aggressively.
2. What stage is it? Is it invasive or in situ? (Stage is the extent to which the cancer is present. Stage 0 is in situ, meaning in place or non-invasive. Stage I is confined to the tissue of origin. From Stage II to Stage IV describes the extent to which the cancer has spread to additional tissue.)
3. What are the lymph nodes and how are they connected with the cancer?
4. What are my treatment options?
5. What treatment do you recommend in my case? Why?
6. What is the goal of the treatment?
7. What are the side effects or risks of the treatment? Temporary, long-term, delayed?
8. What are the risks of not having the treatment?

9. Where can I read about the latest medical studies on treatment and cures of cancer?
10. Will the treatment hurt or be uncomfortable? If so, how can I prevent or lessen the discomfort or improve the outcome?
11. How long will the treatment take?
12. How often will I take this treatment?
13. Will the treatment affect me emotionally or sexually?
14. How can I get copies of the pathology report or other tests to take to another doctor for a second opinion?
15. What clinical trials are available and advisable for me?

1. If the treatment is surgery, please describe it to me. What exactly do you remove?
2. Where will you make the incision? What will it look like when it's healed?
3. What complications might arise from the surgery?
4. How long will I be in the hospital?
5. How will the timing of the surgery affect the prognosis? Is there a concern about having surgery around the menstrual cycle?

1. What kind of medication will I receive before surgery? I have a history of allergies, diabetes, heart trouble, etc. Is there an alternative anesthesia that would be best for me?
2. Are there any side effects?
3. Are there any risks?
4. How long will it take to come out of the anesthesia?

1. What did the biopsy show?
2. What were the results of the hormone receptor assay (to determine if the cancer's growth is influenced by hormones)?
3. During breast surgery, will you remove nodes from my armpit? Why?
4. How will I look after the surgery?
5. Will I experience lymphedema? (Lymph node removal sometimes causes lymphedema, a swelling of a limb, which happens because of abnormal flow of lymph fluids into and out of the limb.)
6. Do you perform sentinel node biopsy?

1. What kind of reconstruction would you recommend for me and why?
2. Describe the reconstruction in detail.
3. When should I have the surgery? Will the surgery allow reconstruction or corrective surgery later?
4. What are possible complications?
5. How many of these operations have you performed in the past year?
6. Can I see photographs of your work and interview some of your patients?

1. Do you think I should have chemotherapy? Why? For how long?
2. How does chemotherapy work? How effective is it? How does it affect the rate of recurrence and survival?
3. What are possible side effects? Short-term, long-term?
4. Will I lose my hair?
5. Will chemotherapy hurt or be uncomfortable?
6. How can I control the side effects?
7. What drugs will I be receiving? How will they be administered? How often? How long?
8. What will happen to my sexual life after treatment?
9. Will the treatment affect my ability to have children?
10. Can I continue with chemotherapy if my blood count is low?

1. How often and how long will it take?
2. Is it safe? Will I become radioactive after radiation?
3. What are the side effects? Will I become infertile?
4. How can I control the side effects?
5. Will I lose my hair?
6. What happens to my skin during radiation therapy? Will the treatment leave a scar or permanent skin discoloration?
7. What will happen to my sexual life after treatment?
8. Will the treatment affect my ability to have children?
9. Can I continue with radiation therapy if my blood count is low?

1. What will help me maintain a healthy diet during treatments? Can vitamin supplements or other nutritional supplements help?
2. What is the best thing to eat to control nausea? Diarrhea?