Before agreeing to chemotherapy: 

• In general: 
  • Keep in mind that it is your right to decide what treatment to undergo - or even to refuse treatment. 
  • Usually there is time before a decision has to be made. Ask the doctor how much time you have without endangering your health. You can take the time to explore the treatment and alterantives until you feel comfortable.
• Before asking questions:
  • Before focusing on questions to ask, it helps to think about what is most important to you about your treatment. For example, you may want to take a treatment which has the least effect on your work, or one with the least side effects. 
• Questions to ask
  • Ask every question that is important to you and get answers that you understand.
  • If the doctor doesn't have time to answer your questions, ask when you can speak again to cover the rest of your questions (via phone, fax, e mail or in another appointment.) If the doctor doesn't have time, you can ask a nurse, social worker or navigator. 
  • For a list of suggested questions to ask about chemotherapy, click here. 
  • If you would prefer to create your own list, you can keep track of your questions with our Prioritizer. 
    • Write questions as you think of them. 
    • Before you go to the doctor, you can number the questions in order of priority to you. 
    • A click of a key will shuffle your questions into the order you want. you can then print the form and take it with you.
  • NOTE: Do not worry that a question will sound "silly" or "strange" to your health care team. They know you want to understand your treatment plan.
• Consider taking with you to each appointment where a potential treatment will be discussed:
  • A family member or friend to act as a patient advocate to help ask questions during the meeting and to discuss the answers afterward.
  • A recording device to record what happens during the appointment so you can review it later. (Many mobile phones include the ability to record.) You will also be able to play the recording for other concerned friends or family members. (NOTE: Ask the doctor if it is okay before recording the conversation.)
• To be sure you understand the answers to your questions, consider the following. 
  • Repeat the information back to your doctor and ask if your understanding is correct. This is particularly imporant with respects to the risks, benefits and alternatives to a particular treatment.
  • If it would help you, ask the doctor to show you a visual such as an x-ray or scan provide or draw a diagram, or point you to an online video. 
• If more than one treatment is available, after asking questions about each individual treatment, ask your doctor: "If you had a child of your own in my situation, what would you suggest he or she do?" Asking what the doctor would recommend to his or her child allows the doctor to express an opinion hypothetically which may lessen fears about liability that could prevent the doctor from giving an opinion.
• If one treatment doesn't clearly fit your goals better than another one, consider using our Treatment Evaluator to help you make an informed decision.

Consent Forms: You will likely be asked to sign a Consent Form before treatment starts. Too frequently, the form is given when you are about to start treatment. It is preferable to get a copy of the form well ahead of any treatment so you have the time to read and absorb the information at your leisure. Medical consent forms are usually printed and look like they cannot be changed. However, you have the right to make any changes you want. For more information about medical consent forms, click here. 

If you want to refuse a treatment, but have difficulty saying so to your doctor, see "How To Refuse A Treatment" 

NOTE:

• For questions to ask about other treatments, see:
  • Lifestyle Change
  • New Device
  • Radiation
    • External Radiation
    • Internal Radiation
    • Intraoperative Radiation Therapy
  • Surgery,
  • Other Treatments
• On a related subject, for information about how to choose a drug, click here.
• If you haven't before, this is a good time to execute legal documents known as Advance Healthcare Directives so that if something happens, your wishes will be honored even if you become unable to communicate for yourself.  They are free and do not need a lawyer to execute them. 

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?
    • If the chemo will damage your chances, consider Methods of Preserving Fertility
• 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?

• 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.