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Questions To Ask Before Agreeing To Chemotherapy

Questions To Consider Asking About Chemotherapy

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Following is a list of questions to consider asking before agreeing to a particular chemotherapy. Feel free to eliminate questions that have been covered or are not of concern to you, to add your own questions, and to print a copy to take with you to the appointment with your doctor.

  • Disease
    • What is my disease?
    • What is the stage and grade? What do these words mean?
    • What is the size of my tumor? Where exactly is it located?
    • What is my prognosis? (Keep in mind that a prognosis is an estimate of outcome based on statistics. Statistics relate to large numbers of people and do not predict what will happen to any particular individual. For more information about why statistics do not predict what will happen to a particular individual, click here.)
    • Where can I find information about my disease and stage?
  • Tests
    • What diagnostic tests or procedure are needed? 
    • How often will the tests be done?
    • How will the tests affect my treatment?
    • What can I do to prepare for each test or procedure?
  • The Treatment
    • What is chemotherapy? 
    • What is targeted therapy? 
    • What treatment do you recommend? (What drug or drugs?)
    • What will the drug(s) do?
    • What are the benefits?
    • What are the risks?
    • What is the expected timeline?
    • How will this treatment affect my outlook (prognosis) for cure or long-term survival?
    • How will we know if the chemo is working? 
    • Will I have to pay for the tests? If so, how much?
  • Treatment Goal(s)
    • What is the goal of the chemotherapy?  Is it Is it to cure me? To eliminate evidence of the disease? To relieve me of my symptoms? Something else?
    • What are the chances the chemo will reach the goal? 
    • Are there other ways to get to the same goals? 
      • If so, what are they? 
      • What are the pros and cons of each alternative?
  • Reasoning For Recommending A Particular Treatment
    • Why do you recommend chemotherapy in general?
    • What is your reasoning for recommending this particular chemotherapy or combination of drugs? 
    • What is the standard treatment for my situation?
    • If you are age 65 or over, ask: Does my age have anything to do with the recommendation? (Some doctors have a bias against recommending certain treatments to older people even though age has not been proved to be relevant.)
  • Should I consider my family history of cancer before making a decision about treatment?
  • Are there other ways to get to the same goals?
  • Are there cutting edge treatments available through a clinical trial? If so,
    • What is the purpose of the trial(s)?
    • What kinds of therapies, procedures and/or tests will I have during the clinical trial?
    • How do the possible benefits and risks compare to available approved treatments that could work for me?
  • The treatment and how it is given:
    • When will treatment start?
    • When will treatment end?
      • Generally chemotherapy is given as a course of treatments, with cycles in each treatment. A course can take 3 - 6 months, but can also be more or less time.
      • A cycle includes the time when you have your chemotherapy treatment and then a break before the next treatment to allow your body to recover.
    • How will I take these drugs? For example, by mouth or through a vein?
      • Will I need a port or similar device? 
      • If so, what choices do I have about where it is placed?
      • What do I need to know about keeping the device functioning?
    • Where will I be given the drugs? For instance, at an outpatient clinic? In the hospital? At home?
    • How long will each treatment take?
    • Will I need someone to drive me home afterward?
    • How often will I need to take a treatment?
  • Risks
    • What are the risks of the chemotherapy you are recommending? 
  • Side effects
    • What are the common side effects?
    • Will I lose my hair? (If the answer is yes, start preparing now. Click here)
    • What are the not-so-common side effects?
    • How do the side effects of this chemo compare to side effects of other treatments?
    • Is there a general time when side effects start?
    • Is there a particularly bad time (such as the day or two after treatment)?
    • When should I expect a minimum of side effects or no side effects during treatment?
    • Is there any way to prevent side effects?
    • Is there any way to make these side effects less severe?
    • How long do the side effects last?
    • Are any side effects permanent?
    • What side effects should I contact you about? What's the best way to contact you?
    • For a list of general side effects from chemotherapy and what to do about them, click here.
  • Pregnancy/Fertility
    • Will the treatment affect my ability to have children? 
    • If so:
      • How can I bank my eggs or sperm? (For information, click here).
      • Are there alternatives which would not affect my ability to have children?
  • Work
    • What effect will the proposed treatment have on my work?
    • Will that change over time?
    • How can we schedule treatment to minimize the effect on my work? (With many chemotherapy treatments, a day of rest is needed. If treatments are scheduled for Friday afternoon, most people are fine when returning to work on Monday.)
    • If I have to stop working, how long will that be?
    • How will I know if I am overdoing it at work? 
    • If it would be helpful to me, would you be willing to talk with my supervisor about my condition and how it could affect my work?
  • How will this treatment affect my other daily activities?
  • What can I do to prepare myself for this treatment?
  • What do I need to do to take care of myself during treament? For instance:
    • My diet?
    • My activities? (Are there activities I should do or should not do to take care of myself?)
    • Exercise? (Being active during treatment is something you can do to help lessen side effects and improve the chance for successfully completing treatment. Your doctor can provide advice about what exercises you can and cannot do. For information about exercise for survivors, click here.)
    • Sexual activities? (For information, click here.)
  • Are there special services for patients receiving chemothearpy such as certain parking spaces or parking rates?
  • Will I need other treatments such as Surgery and Radiation?
    • If so, when and why?
    • Why are you suggesting chemotherapy first?
    • What results can I expect from each type of treatment?
  • If I take this treatment, are there other treatments that I will not be able to take in the future because I took this treatment?
  • After treatment ends:
    • Will you give me a cancer follow-up plan? (To learn about a cancer follow-up plan, click here)
    • How often will you want to see me?
    • What tests will I need to take?
    • Can I get copies of my laboratory test results? (It is always a good idea to keep copies of all your lab test results.)
    • How will you determine if the cancer has come back?
    • What should I do to help prevent a recurrence in addition to adopting a cancer prevention diet and lifestyle?
  • If the chemotherapy doesn't work:
    • Are there other approved treatments for me?
    • Are there experimental treatments which are available through clinical trials that may work for me?
  • Finances
    • How much will chemotherapy cost?
    • How much will the tests cost to see how the chemotherapy is working?
    • Will the costs be covered by my insurance or health plan?
    • Where can I find help with managing the cost of cancer care?
  • What support services are available to me? To my family?
  • If the insurance company requests a second opinion, or if I would like one:
    • Who do you suggest I see?  Why?
    • Who in your office will be responsible for getting slides and other necessary information to the doctor who will give a second opinion?
  • How can I contact you:
    • With additional questions before I start treatment?
    • Once I start treatment, after office hours if I have signs or symptoms that you need to know about?
If you are a member of an HMO or other managed care health insurance plan, ask:
  • Does the insurer provide financial incentives for doctors to use a preferred treatment?
  • Is the doctor prohibited from informing you about treatment options other than the one or ones approved by the managed care company? This is a practice known as "gagging" the doctor. "Gag orders" are supposed to be a thing of the past. However, it is still worth confirming that you have been advised of all of your treatment options.
  • Does the plan limit your doctor's choice to order treatments and make referrals if a patient's needs go beyond the plan's protocols?

NOTE:

  • If you have difficulty getting the doctor to answer your questions, see the video, Talking With Your Doctor, and/or read How To Work Most Effectively With Your Doctor.
  • If the doctor doesn't have time to answer all your questions when you are together, ask what is the best way to ask your additional questions. The doctor may set another appointment or suggest you send them by e mail or perhaps speak with another doctor or nurse in his or her practice.
  • For information about dealing with the stress of waiting for a procedure, click here.

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