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Questions To Ask Before Agreeing To A Treatment Plan For Breast Cancer

Questions To Ask Before Agreeing To A Treatment For Breast Cancer

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Questions To Ask About Your Diagnosis

  • What is my diagnosis?
  • What is the stage of my cancer and how does it affect my treatment options and prognosis?
  • Has my cancer spread to lymph nodes or internal organs? [The lymphatic system of the breast drains primarily into the lymph nodes of the armpit (the axilla). Because of this, doctors need to see whether cancer is present in the underarm lymph nodes. Only a few nodes need to be removed for examination. If they are disease free, no additional nodes have to be removed.]
  • Are there other tests that need to be done before we can decide on treatment? For example, should I consider genetic testing? (Women who carry the BRCA1 and BRCA2 genes with specific mutations have an increased risk of developing both breast and ovarian cancers).

Questions To Ask About Treatment

  • What is it that you are proposing? Please tell me in terms that I can understand.
  • What is the goal?
    • What are the chances of achieving the goal?
    • How long will the benefits last?
    • If the goal is to get rid of the cancer, what are the chances my cancer will come back with the treatment programs we have discussed? What would we do if that happens?
  • What are the risks?
  • What affect will the following have on my ability to do my work? 
    • Treatment
    • Recovery from treatment
    • Long term effects
  • If surgery is proposed, with respect to therapy in addition to surgery such as chemotherapy or radiation ("adjuvant therapy"):
  • What are the alternatives? What are the benefits and risks of those alternatives?
  • Why do you recommend one treatment over another? 
    • Is your recommendation based on clinical studies of what works best and what does not, or is it based on informed opinion, personal observation or tradition?
    • Some clinical studies result in "clinical treatment guidelines" issued by a reputable medical organization. If there is such a guideline for my health situation, is the treatment within the guidelines? If not, why are you proposing something different? 
    • If there are studies, where can I find them if I want to?
  • Will the treatment prevent me from getting other treatments in the future?
  • What would happen if I choose to delay treatment? To have no treatment at all?
  • Is there any written information I can read? If so, how can I get a copy?
  • If you are age 65 or over: Ask whether your age has 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.

Questions To Ask About Your Breasts

  • What will my breasts look and feel like after my treatment? Will I have normal sensation in them?
  • If your breasts will be removed:
    • How effective will breast reconstruction surgery be if I need or want it?
    • If I want to do breast reconstruction, when should I do it?
    • What plastic surgeon would you recommend to do reconstruction?

Questions To Ask About Side effects

  • Will the treatment be painful? If so, what can be done to control the pain?
  • Will I be able to have children?
    • If not, who do you suggest I speak with about banking sperm or eggs?
  • Will I go through menopause as a result of the treatment?
  • Will there be other side effects? What can be done to prevent or minimize unwanted side effects?
  • How will the treatment interact with other drugs or treatments I may be using? (If you will be asked to discontinue use of a currently prescribed drug, let the prescribing doctor know you will be taking a drug vacation. He or she may propose an alternative.)
  • Will the treatment affect my ability to work? If so,
    • How will it effect my work?
    • For how long?
    • 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 women are fine when returning to work on Monday.)
    • How will I know if I am overdoing it at work?
    • If it would be helpful to speak with my supervisor about my diagnosis and/or treatment, will you be available to do that?
  • Will the treatment affect my daily life? If so,
    • In what way?
    • For how long?

Questions To Ask About Finances

  • How much will the treatment cost?
  • Does my insurance cover the cost of treatment?  (If not, see Uninsured.)

Other questions to consider

  • How much experience have you had performing the recommended treatment?
    • Over how many years and how many patients? 
    • What have your results been?
  • How long and how often will I have this treatment?
  • How will we know if the treatment is working? How long will it be before we know?
  • "If you had a child of your own in my situation, what would you suggest he or she do?" (With a question stated like this, you can find out what the doctor thinks without putting him or her on the spot of seemingly being asked to make a decision for you.)
  • Do you recommend that I obtain a second opinion from another doctor? If not, why not? (For information about second opinions, click here.)
  • Will I be asked to sign a consent form before undergoing the treatment? If so, can I get a copy now or at least before I have to make final decision? (Consent forms list all the risks of a treatment and who will perform it).
  • Do you have a financial interest in my decision, one way or the other?
  • If I do some research about the treatment and have questions, when can I ask them?
  • What should I do to get ready for treatment? For example, should I follow a special diet or make other lifestyle changes?
  • Will I need a blood transfusion?  (If so, consider banking your own blood.)
  • Ask a "catch all" question such as "Is there anything else you would ask if you were me, or anything else that I should be aware of?"
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."  Gagging is 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: It is helpful to obtain a copy of your medical records, pathology reports, and radiology reports in case you wish to seek a second opinion now or later.


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