The treatment of cancer requires a multidisciplinary medical team approach, which can add to the confusion of a new diagnosis. Being able to effectively talk and listen to each doctor in your medical team may facilitate the step-by-step approach essential for optimal cancer treatment. But, how do you effectively talk to your doctor? You may wait days or weeks for an appointment and travel significant distances for a specialist, only to actually see your doctor for 15 minutes. To optimize those 15 minutes, you need to understand your doctor’s role in your medical team and educate yourself about your disease and its treatment before your appointment. You should also get organized and arrange for a spouse, friend or relative to accompany you to the appointment. To effectively talk to your doctor at the appointment, do not be intimidated, ask questions and have a companion write down the information that the doctor provides. In addition, with your doctor’s consent, you should tape record the consultation, as well as request written recommendations.

Understand the Importance of a Medical Team and Treatment Coordinator

Unlike some diseases or medical conditions, most cancer treatment is multifaceted, involving diagnosis and staging, gathering information, exploring treatment options, getting second opinions, undergoing treatment and receiving follow-up care. Each step of cancer treatment may involve several doctors and nurses that make up a medical team. A member of the medical team should be the designated treatment coordinator to oversee your treatment and facilitate interaction with other members of the medical team.

Educate Yourself

Use many resources to investigate your disease and treatment options and to define specific questions that only your doctor can answer. Resources should include your medical team, second opinions, books, the Internet and other patients with your disease. As you investigate, make an ongoing list of questions and organize your questions before your appointment.

Doctor-Patient Relationship

Most importantly, don’t be intimidated! Most cancer patients would advise that to receive optimal care, it is best to view each doctor in your medical team as a partner in your treatment. Don’t worry about asking questions or being an inconvenience; your doctor is working for you.

Preparing for the Appointment

Before your appointment, contact the doctor’s office to determine the medical records or paper work that your doctor will require before your appointment. This will help the doctor be prepared for you.

Invariably, you may forget to ask a question or a new question or concern may arise after your appointment. Consequently, before you leave your doctor’s office, establish a way to contact your doctor with subsequent questions. Although it may not be practical for your doctor to directly receive calls, your doctor’s nurse may be available via messaging, voice mail or email.

At the Appointment

At the appointment, use your list of questions as a guideline to issues you want to discuss with your doctor. Remember, while your doctor will do his/her best to provide information, he/she cannot read minds. It is up to you to ensure that all of your concerns and questions are addressed. If your doctor says something you do not understand, stop and have him/her clarify. For example, your doctor may order CT scans daily for patients and you may have never heard of a CT scan. Find out what the scan is looking for and why you are having it.

Studies have shown that bringing a companion to your appointments, requesting written recommendations and tape recording the appointment (with your physician’s consent) facilitate information recall and patient satisfaction. In one study, the addition of an audiocassette recording to written recommendations significantly improved a patient’s recall after the consultation.¹ In addition to consented tape recording, the presence of a companion at the appointment is important. A companion can offer support, write down information your doctor provides or ask questions that you might not feel comfortable asking.

Absorbing the Information

To appropriately absorb the information your doctor has given you, it is important to understand your doctor’s perspective and consider the source. Your doctor is giving you information that he/she thinks you need and want to hear. For example, some patients do not want to hear all of the information and only want to be told what to do. On the other hand, patients who want all of the information and treatment options may have to be more persistent. Also, consider the varying degrees of experience in your medical team, which result in different perspectives and specialties that permeate the advice your doctors will provide. For example, a specialist dealing with a particular disease daily will have a different perspective than a general practitioner dealing with a particular disease a few times a year. Similarly, a surgeon may not be the best source of information on other treatments like chemotherapy or radiation. Furthermore, a doctor or facility that only offers standard treatment may not be the best source for information on experimental treatment. With any resource, get a second opinion(s).

Information presented in The Daily Tip is offered as a guide to augment a patient’s research of cancer and treatment and does not replace the advice of a doctor. For more information on a specific cancer, go to www.CancerConsultants.com, www.cancer.gov, and consult your physician.

Reference: 1. Bruera E, Pituskin E, Calder K, et al. The addition of an audiocassette recording of a consultation to written recommendations for patients with advanced cancer: A randomized, controlled trial. Cancer. 1999;86:2420-2425.