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Medical appointments can be stressful. To better deal with this stress, we suggest you prepare yourself before walking in the door to meet with any member of your health care team. This means having your questions thought through and written out. Begin with your most critical questions to be sure of getting the most important answers. If you are not clear on the response, ask for clarification. It can also be helpful to have someone with you to take notes and be a second pair of ears.

Our members living across the country in cities, towns, and rural areas suggested these questions. The questions were further reviewed and evaluated by Dr. Ann Partridge at Dana-Farber Cancer Institute in Boston, Massachusetts.

These questions are offered to help you focus on the information you need. Use them as a guide to select which questions are most relevant for you.

If diagnosed by your primary care physician:

Where do you send your metastatic patients for treatment?

If I am sent elsewhere for treatment, how will you communicate with the other doctor?

 

When choosing your cancer doctor:

How much experience do you have treating this type of cancer?

Do you have other metastatic breast cancer patients at this time?

If needed, do you have colleagues with whom you can consult?

Do you enroll patients in clinical trials? If I should want to participate in a trial, would you help me find an appropriate one?

How do you keep up-to-date on medical findings?

What is the best way to contact you or your team between visits if I have a concern? by phone? by e-mail?

 

Find out if this doctor is covered by your health insurance plan. Ask about out-of-pocket costs.

Explore the pros and cons of treatment in a medical/cancer center vs. treatment in a community-based medical office. Consider distance from home, availability of specialists, access to clinical trials, availability of support services and local resources, familiar atmosphere, need to travel for scans and various treatments. Be aware that it is not uncommon to travel to appointments several times a month.

If you are using a local doctor in addition to a doctor at a cancer center, find out if the doctors will work together and arrange for some treatments and scans to be given locally.

Consider your level of comfort in communicating with the doctor. Does the doctor encourage questions? listen to your concerns? allow another person to be present with you at visits? treat you as you wish to be treated?

 

 

To better understand your diagnosis:

What does a metastatic cancer diagnosis mean?

To where has the cancer spread?

Will a biopsy be needed? why or why not?

What is the cancer sub-type? ER+, PR+, HER2+, or Triple Negative?

 

To better understand your treatment:

What are my treatment options?

Which treatment do you recommend? why?

Will this treatment enable me to live longer? live better? live longer AND better?

What are the possible short-term side effects of this treatment?

What are the possible long-term side effects of this treatment?

Which side effects do you want me to report to you? how?

How do I get help to relieve possible pain? nausea? fatigue?

How often will I need treatment? Can I do any of this treatment at home or at my local doctor’s office or hospital?

Will this treatment interfere with any medications I am presently taking? affect other health problems I presently have?

Do you recommend I get a port (an implanted device, generally in the chest area, through which blood is drawn and drugs are infused without repeated needle sticks)? why or why not?

Do I need to take a bone strengthening medication such as Zometa? why or why not?

Do I need to complete dental work before starting treatment?

 

Treatment for mbc is ongoing, and treatment plans change as the disease progresses, or a patient becomes intolerant of a particular treatment.

A particular treatment may fail you. You do not fail the treatment.

Different treatments have different side effects. You have the right to decide what is most important to your quality of life and to communicate this decision to your doctor. Be aware that this decision may limit the options your doctor offers. We suggest you be receptive to hearing all your options.

 

To better understand your ongoing care:

What tests/scans do I need, and how often will I need them?

How will you determine if the treatment is working?

 

Successful treatment for mbc does not necessarily mean that the cancer has disappeared. Treatment, in most cases, can be considered successful if the disease diminishes or remains stable, and symptoms are under control. People can live many years with cancer in their body.

No Evidence of Disease (NED) is possible, but not very common.

 

To better understand supports available:

What support services are available to me? to my family?

Do you have information on a metastatic support group I can join?

How do I get a referral to see a psychologist? social worker? nutritionist?

How do I get help for anxiety? depression?

How do I get help with managing the cost of my cancer care?

Who handles health insurance concerns in your office?

Who can help with disability and social security paperwork, if needed?

How can I arrange for transportation for treatments?

 

Be sure to inquire what your health plan covers.

 

General suggestions:

A second opinion is recommended; it’s best to have your second opinion doctor be at a different medical center/group.

Write out your questions before each appointment.

Keep a notebook where you can record doctor comments, appointment dates, symptoms, and other important information.

Get copies of important scan reports, and start a file for yourself at home. If you see another doctor, the reports will be there to take with you.

Decide how much information you want about your medical status, and communicate this to your doctor; this decision can always be revised.


 

HOW TO FIND A DOCTOR AND CANCER CENTER:

for an informative factsheet from the National Cancer Institute(NCI), click HERE.

 

for a list of NCI Cancer Centers, click HERE.

 

 

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