It’s frightening enough having to face a diagnosis of a life threatening disease such as cancer, without the unnecessary stress and anxiety that lack of communication with the cancer specialist can produce.
In my experience I have found that after a diagnosis of cancer , the first meeting between an oncologist and new patient is often one-sided . Whereas you might expect that it would be a session packed with questions and clarifications, more often than not it ends up with the oncologist rattling off the implications of numerous tests and the ever so complicated and daunting treatment regimen.
This usually leaves patients looking lost, as if they are in some faraway place within the deep recesses of their minds.
To ensure that you derive maximum benefit and clarity at the first visit I have compiled a short list of general questions that you need to address and get answers for at this very important meeting.
In much the same way as you would not go into a critical deal clinching meeting unprepared, you need to be properly prepared for a meeting with your oncologist. Here are some tips:
*Know your disease.
Try and read up on the diagnosis. There are many good Internet websites dedicated to cancer and its management. It is also true that there are sites that are a waste of time at best, or at worst can represent a danger and false hope along with incorrect information. It is important not to visit sites aimed at medical professionals, but rather those that are dedicated to patients and their families. These are generally easier to understand and give relevant and practical information.
I have found that when patients read medical journals, inevitably there is undue anxiety, confusion and a high probability that information may be misunderstood or taken out of context. Educating yourself prior to the meeting will ensure that it is fruitful and will enable you to ask all the right questions.
*Know the stage of the disease
Every cancer has a stage assigned to it, for treatment and prognostication purposes. Ask your oncologist what stage your cancer is, to enable you to construct reasonable expectations.
*The treatment
By this time you will have a broad idea of what the treatment may entail from your reading. Your oncologist will, usually after taking a medical history and examining you, spend a fair amount of time discussing this. Listen, and hear the rationale behind the treatment plan. This is your time to define clearly together with your oncologist, the aims and goals of treatment. You also need to outline your wishes, so that these can be taken into account when deciding on the approach. Remember that the treatment will as far as possible, and without compromising outcomes, be tailored according to your specific situation and clinical issues. It is also important to ask how often you will be getting the treatment, the duration of the treatment and the impact it may have on your activities of daily working and living.
*The side effects.
These will differ from patient to patient. Some oncologists prefer not to discuss the side effects in full at the very first visit. However, you are entitled to ask any questions you like. If you feel strongly about having that discussion then instead of leaving it to a subsequent visit, ask your oncologist to outline the important side effects related to your treatment, and what treatments are available to alleviate them.
*The prognosis
This is always a difficult subject to discuss, both for the patient and the oncologist. It is important to realise that you may not always get as precise an answer as you may desire. Often a patient may ask, “How long do I have to live, doctor?” The reality is that no one can reliably predict how long you or anyone else will live. Discussing mortality is uncomfortable, even for the most seasoned oncologist, as it reminds us all of our own mortality. Some oncologists will give you time frames as per your request, based on experience and clinical trials which will not be specific to your situation.you will,however be encouraged to utilise the services of a hospice,should you be deemed to be terminal .
It is also worth remembering that modern medicine has made huge strides in the fight against cancer, and depending on the stage of the disease at diagnosis, many patients do survive the disease, and go on to live long full lives.
This is the first in a series of monthly columns in which I will discuss the different cancers and their specific issues.
*Dr Keo Mafafo is a specialist physician and medical oncologist at the Sandton Oncology Centre, Rivonia Rd, Sandton.
