People often leave their doctor's offices irritated with themselves for not asking what they wanted to ask. Sometimes they simply forget to ask. (I encourage people to bring a list). On other occasions, though, people aren't sure if it's OK to ask certain questions. Sometimes the questions that people hesitate to ask are the ones that they're most concerned about. These are some of those questions:
How much will this cost? Being treated for cancer can be incredibly expensive. In general, people want to know what they'll have to pay out of their own pocket. Someone in the medical office should be able to give you a reasonable estimate of what your insurance will pay and what will be your responsibility.
Is there a less expensive alternative? We all want the best possible care and physicians want us to have that care. But say, for example, that you have no health insurance at all and you're paying from your life savings. The newest and best drug for your cancer might cost $50,000 for a course of treatment. An older generation drug might be 95% as effective as the newest drug, but cost only $1,000. Is that a reasonable trade-off? It's an individual decision, but it's fair to ask the question.
What's the likely benefit from a proposed treatment? Cancer treatment is about improving your odds of preventing a recurrence and extending your life. You can ask, "How much will this chemotherapy/radiation/surgery improve my odds of preventing a recurrence?" Sometimes the likely benefit is huge, sometimes the benefit is small, and sometimes it's uncertain.
Do I need ALL of the proposed treatments? Sometimes the suggested treatment includes radiation AND chemotherapy AND hormonal treatment, etc. You can ask, "If I get chemotherapy, what's the added benefit of radiation? Or, if I get radiation therapy, what's the added benefit of chemotherapy?" We don't always have clear evidence, but these are reasonable questions to ask.
How long can I wait before beginning treatment? Some cancers require that treatment begin quickly. Other cancers are slow moving and treatment can safely wait for many weeks. You can quite possibly spend time exploring other options or just going ahead with that long-planned vacation.
How long am I likely to live? Some people want to know their prognosis and others don't. Doctor can't predict precisely how long you will live, but they can give you a general idea of what's typical for people with your condition. It's OK to ask. And it's OK not to ask.
Is hospice a reasonable option? As more and more treatments become available to treat advanced cancers, there's almost always something to try when the current treatment stops working. At some point, many people wonder if it's worth pursuing those additional treatments. You can ask your doctor if hospice is a reasonable option to consider.
Can you repeat that? People usually miss a good deal of what their doctor tells them, especially if it's a stressful time. (Hearing that you have cancer is always stressful). Don't be afraid to ask a doctor to repeat something.
Many of these questions don't have simple answers. People with cancer often have to make decisions with incomplete information. No one knows for certain how an individual will respond to a particular treatment or what the future might hold. Sometimes the answer to these questions will be, "I don't know" or "there's no data on that." But asking questions is always OK.
Reprinted with Permission of the Ithaca Journal
Original publication date: February 18, 2009.