Questions You May Not Think to Ask Your Doctor

Emotions run high in the wake of a breast cancer diagnosis, and there are questions you simply may not think to ask your doctor during this stressful time. Getting answers, however, empowers you to make informed decisions about your care. Y-ME encourages you to ask questions and get the information that will help you be the most important player on your health care team.

“If there is anything you don’t understand about your diagnosis, get clear on it by asking questions,” advises Alison Mayer Sachs, M.S.W., O.S.W-C., coordinator of cancer support services at Eisenhower Lucy Curci Cancer Center in Rancho Mirage, Calif. One of the first questions she urges patients to ask is: What kind of breast cancer do I have? “Not all breast cancer pathology is the same, and the type you have determines the most effective course of treatment,” she notes. Following initial diagnosis, further testing may be required to stage cancer or make a more definitive diagnosis. “Ask your doctor what will be learned from each test,” she suggests. And if you don’t understand a medical term, ask for clarification. Once you have a diagnosis, ask about treatment options. Many women will have choices to make: for example, lumpectomy vs. mastectomy, partial vs. full-breast radiation, reconstruction now, later or not at all. Sometimes a clinical trial is appropriate. Ask about the benefits and risks of each option.

“There’s so much information to process, it can feel overwhelming,” says Anne McManus, R.N., M.S.N., A.O.C.N., N.P., at the Faulkner Breast Centre in Boston, Mass. “Some women are uncomfortable making these choices. But they need to ask themselves what’s best for them at this particular time, and ask their doctor how their life would change with each choice.” “Also, ask what treatment your doctor recommends,” counsels Sachs. “And get details: How often will I have those treatments, in what order? What side effects should I expect? How long will treatment take?” If you are of childbearing age, ask how treatment may affect your fertility. And, if you are sexually active, how will it affect your libido?

Both Sachs and McManus agree that breast cancer’s impact on their sex lives is the number one topic that patients tend to avoid. “Sex is so vital to our well-being, yet it’s one of the first things to go on the back burner when we’re sick,” says Sachs. “And with breast cancer, it’s not just about sex, but about body image, too.”

What about getting a second opinion? “This is a standard of care today, and patients shouldn’t feel defensive about seeking one. Nor should the doctor,” Sachs notes. “The goal is to confirm your diagnosis and recommended treatment, and to help you feel confident about your treatment decision.” That is why most insurers cover second opinions.

Perhaps the most fundamental question patients ponder is: What are my chances of survival? “Statistics can be very helpful when making treatment decisions,” says Sachs. “They can tell us this number of people got better this percent of the time with this treatment. But human beings are hard to quantify statistically. Each person is unique, and no one has a crystal ball.”

Sachs also advises patients to ask: Who’s the captain of my ship? “There is usually a team of medical professionals involved in a breast cancer patient’s care,” she explains. “You want to know who the doctor in charge is, the one who gets all your test results and coordinates your care.” Generally, she says, the medical oncologist fills this role.

What if you have questions when your doctor is unavailable? Ask your doctor if there is a nurse or social worker you can turn to. Inquire about books, Web sites or other resources your doctor recommends. And ask about support groups, urges Sachs.

“A support group run by a trained facilitator is the best place for answers from other women with the same experience,” she says.

“Above all, you must feel like you’re part of the decision-making about your care,” says McManus. “Treatment results tend to be better when you’re invested.”

Be Prepared for Your Next Doctor Visit

• Keep notepads near your bed, in the kitchen and in the bathroom, and write down questions as soon as they pop into your head.

• Call the Y-ME Hotline at 800-221-2141 to discuss your questions and get suggestions about adding others topics you may not have considered.

• The night before your next doctor’s appointment, consolidate your questions into one written list and prioritize them because you may have limited time with your doctor.

• Bring someone with you to your appointment to serve as a second set of ears and to take notes (freeing you to really listen to what the doctor is saying).

• Tape-record your visit, if possible. You can replay it when you are better able to concentrate, and you can share it with family and friends.

Need help articulating and prioritizing your concerns?
Call the Y-ME Hotline at 800-221-2141 and speak with a trained peer counselor who is a breast cancer survivor.