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The health care community has made remarkable strides over the past 20 years in treating cancer, but more than a million people in the United States are still diagnosed every year. As devastating as that news is, whether you have cancer or are close to someone who does, there are some basic facts to understand about the diagnosis in order to begin moving forward with a treatment program.
After initially advising the patient about the cancer diagnosis, there is often a period of (understandable) disbelief. But once the news has been accepted, it is time to mobilize. Every patient with cancer, in cooperation with family members, needs to ask the treating doctor some important key questions. Even a preliminary view of the future is empowering for the patient who can begin to see the road ahead and "prepare for battle."
It is important to talk frankly with your cancer care team, and it helps if you know what to ask. I recommend that every newly diagnosed person ask their oncologist or treating physician these all-important questions:
1. Is the kind of cancer I have treatable?
This is where any cancer discussion needs to start.
2. What kind of cancer do I have? Where is it located? Has it spread?
Your treatment plan will be constructed based upon this information that will come from the pathology report. Your oncologist will oversee all aspects of your treatment including surgery, chemotherapy and medication, and radiation and recovery.
3. What stage is my cancer?
Cancer staging is a key marker to determine the extent of the disease from which a treatment strategy will be implemented. Ranging from stage 0 to stage 4, the stage assesses the size of the tumor, lymph node involvement, and whether the cancer has spread. The stage is determined after the tumor and lymph nodes are removed and examined by a pathologist.
4. Should I take or continue using supplements (vitamins, minerals, etc.)?
This is heavily dependent upon what kind of treatment protocol you undergo. Many people take vitamins and mineral supplements to support optimal health and nutrition, but first and foremost, I encourage patients to consume high-quality food. Some high-dose antioxidant supplements can lessen the effectiveness of cancer treatment, so it is important to discuss any vitamin supplement usage with your physician or dietitian.
5. Will I be in pain? What medications can ease the discomfort?
Many patients with cancer are already in pain from the disease. Cancer treatment and/or surgery can lessen or even alleviate this pain. When needed, there are pain management physicians who specialize in helping to minimize pain for patients with cancer and who are undergoing therapy.
6. When should I tell my family?
The only person who should make this decision is the patient. It is a very personal preference.
I do recommend that the patient and closest family members (spouse, sibling) be fully informed about the cancer and treatment plan before talking with others. This will lessen anxiety for all involved when there is a clear understanding of the type of cancer and the medical options available to treat it.
The oncologist should be part of the conversation with the family in order to help address questions and concerns. Many of my patients choose not to share their diagnosis with certain parties in an effort to maintain as normal a life as possible throughout the process.
7. What is the standard treatment protocol for the type of cancer I have and what are the downsides?
Once you understand the kind of cancer you are dealing with you can better understand your doctor's plan to treat it. This, along with your age, general health, the location of the cancer, and other contributing factors will all be considered. Sometimes, there are choices for patients to make in order to attack the cancer. Some treatment plans are more aggressive than others. Any protocol will have a downside. Find out the plusses and minuses for each of them.
8. Can you recommend colleagues for a second opinion?
Cancer treatment is never easy. Once the patient commences with treatment, it's important to believe this is the optimal strategy to achieve eventual success. Therefore, it's important to have at least two medical opinions about how best to treat the disease.
9. How will cancer treatment affect my daily life?
For the majority of people, cancer treatment is debilitating to some degree. There is no definitive response to this question but it is helpful and comforting to patients to hear that work, socialization and even physical activity may continue, in some capacity, during treatment.
10. What cancer support services are available?
Patient and family member support is vital to assisting with the physical, emotional and financial challenges that lie ahead. Every family needs to take advantage of these services, including palliative care, which helps to lighten the responsibilities and lessen stress for everyone involved.
Empowering the cancer patient with knowledge
There is an overwhelming volume of new and unfamiliar information to take in during this kind of conversation. If possible, have as many key family members present during this discussion. Take notes and ask the doctor if you are unclear about anything. (Remember, you are paying him for his time.)
After this meeting, convene as a family, with the patient, and express your unified commitment to working together successfully to help your loved one deal with the disease. Each member of this group should warmly assure the patient of their unconditional support throughout this journey.
When a family works as a team to cope with a loved one’s cancer diagnosis, everyone benefits.