Making the Most of Your First Appointment with Your Oncologist

By Esther Napolitano,

Tuesday, March 10, 2015

Pictured: Chau Dang
Summary

Meeting with your oncologist for the first time? Here are some tips for getting the most from that appointment.

If you’ve been diagnosed with cancer, you probably have a lot of questions about your particular disease and what lies ahead. The first step is making an appointment with an oncologist — a doctor who specializes in treating cancer. The knowledgeable staff at our Physician Access Service can help you identify and make an appointment with the most appropriate oncologist to meet your specific needs.

Depending on the type and stage of your disease, your first appointment will usually be with a surgical oncologist, a medical oncologist, or a radiation oncologist. Any one of these specialists can help you better understand your diagnosis and treatment options and work with you to make informed decisions about your care.

We asked Suzanne Carmody, Director of MSK’s Physician Access Service, to explain what you can do to prepare for that first encounter.

What’s the most important thing I should do before my first meeting with my oncologist?

The first thing the oncologist will ask about is your medical history. When you get into the doctor’s office, it’s very easy to forget when things happened, so it’s helpful to write down your history to remember the timeline of events. Keep notes about your symptoms and what made you go to your doctor in the first place. What tests did your doctor order? Were you referred to additional specialists? Have you previously been treated for cancer?

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What should I bring with me?

In order to make it a thorough consultation, the oncologist you’re meeting with should have all your reports and other requested materials. This includes copies of scans, x-rays, MRIs, CTs, or other imaging tests that were done, and pathology slides if a biopsy was performed.

In addition, we always ask that you bring in any medications you take, including over-the-counter pain relievers, vitamins, herbs, and supplements. Rather than just making a list, we ask that you bring in the actual medicines so we can note the dosages. Before recommending a treatment, doctors have to know what you’re taking in order to make sure there are no potential interactions. People may forget things like calcium and vitamin D, but those can interfere with some treatments.

Bring a family member or a friend to be another set of ears in the room.
Suzanne Carmody Director of MSK’s Physician Referral Service

We encourage you to take notes during your appointment. If you can, bring someone with you — a family member or a friend — to be another set of ears in the room. In addition to providing emotional support, they can help you remember what the doctor says, take notes for you, and remind you of key questions that you don’t want to forget to ask.

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What are those key questions?

I think the most important thing to do is to listen to what your oncologist has to say, because a lot of your questions may get answered, and listening closely may make you think of additional questions.

Having said that, here are some things that are helpful to discuss during your first appointment:

  • What is my diagnosis and how soon do I need to start therapy?
  • What are my treatment options, what’s involved, and how long will each treatment take?
  • What are the benefits of the recommended treatment?
  • What are its potential risks and side effects?
  • Should I consider participating in a clinical trial?
  • How will treatment affect my daily routine? Can I continue to work through treatment?
  • Will treatment impact my fertility? If so, is there anything I can do to protect my ability to have children in the future?
  • What should I do if I develop new symptoms after I begin treatment?
  • What support resources are available to help me cope with my diagnosis?
  • Whom should I call if I have additional questions after I leave the office?
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Can I expect my oncologist to give me a sense of my prognosis during my first appointment?

We see people do better than expected every day.
Suzanne Carmody

Yes, as part of your consultation, your physician will discuss your disease, treatment options, and prognosis. Your prognosis [the doctor’s prediction of how you’ll recover from your illness] depends on the type of cancer, the stage of your disease when first diagnosed, and your response to treatment. Some cancers are not curable but may be treatable with therapies that provide you with as much quality of life as possible.

Physicians are honest and hopeful, so even if the general statistics look discouraging, each individual is unique and may respond differently to therapy. Depending on your response, your oncologist may recommend a newly approved treatment or a novel drug being evaluated in clinical trials. We see people do better than expected every day.

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Comments

I am corectal cancer patient living in Delhi,India wants to have second opinion of my treatment

3 yrs post op thyroid cancer. & now, new biobsey is positive for lymp node cancer. They sent me to an oncologist , but also to a cancer doc that is radiologist. They are both cancer docs, is that common to be sent to 2 docs? One works through, "Comprehensive Blood and Cancer Center" . He's suppose to be radiologist, but I thought an,"oncologist" does that also?? Please help with any knowledge u have thank-you

Dear Jennifer, we are sorry to hear about your diagnosis. There are a number of cancer specialists a patient might need to see, depending on their particular needs and circumstances.

A radiologist specializes in imaging tests that are used for diagnostic purposes and to gauge how well a treatment is working over time. A medical oncologist is typically in charge of your overall cancer care and treatment plan, which may include chemotherapy or other medicines.

You may be interested in learning more about the various members of the team of specialists that may care for your during your cancer experience: https://www.mskcc.org/cancer-care/treatments/your-care-team

Thank you for reaching out to us.

I have been diagnosed with Cholangiocarcinoma. The PET Scan indicated no lymph node involvement. I was also encouraged to seek treatment at Sloan Kettering. Does it take a long time to process requests?

Dear Michael, we are sorry to hear about your diagnosis. If you would like to request an appointment with a specialist at MSK, please call our Physician Referral Service at 800-525-2225. The staff there can answer your questions about timing and information and materials you will need to send in prior to your visit. Thank you for reaching out to us.

I have been diagnosed with prostate cancer , have had ct scan & bone scan. Am anxious to start treatment asap. Please help.

Dear Lawrence, we are sorry to hear about your diagnosis. If you would like to make an appointment with one of our specialists, please call our Physician Referral Service at 800-525-2225. For more information about making an appointment and receiving treatment at MSK, please visit https://www.mskcc.org/experience/become-patient/appointment. Thank you for reaching out to us.

My mom was just told she has cancer but they don't know what kind and where it's coming from. But yet we r being sent to an oncologist. Wouldn't it be smart to find out what type it is first thru her medical doctor. I'm very confused. There was only a cat scan done. I would think they would need to do a pet scan. Can you please try to explain this to me a little bit

Donna, thank you for reaching out. Your mother may have been diagnosed with what is called Cancer of Unknown Origin:

https://www.mskcc.org/cancer-care/types/cancer-unknown-primary-origin/a…

We suggest you ask her treating physician or her oncologist to whom she has been referred what kind of tests she needs for an accurate diagnosis.

If you would like to make an appointement at Memorial Sloan Kettering for consultation, please call our Physician Referral Service at
800-525-2225 or go to

https://www.mskcc.org/experience/become-patient/appointment

Thanks for your comment.

Hi, I'm in Alabama and feel the quality of care here is horrible. My blood work has been off for 2 years and now they finally took the time to realize it. Does that mean I have fewer options now?

Dawn, we're sorry to hear that you've been unhappy with the quality of your care. If you've been diagnosed with cancer, you might want to go to this list of National Cancer Institute-designated cancer centers to find one that is convenient for you. There is one in Alabama. http://www.cancer.gov/research/nci-role/cancer-centers/find Thank you for your comment.

My cousin has been diagnose with Chondrosarcoma. It took 15 months till the doctor finally ordered a vascular test. His symptom was swelling of his right leg. Then when he cough up blood, they did a CT scan of his lung and determined blood clog. He was on Xerelto with the doctor assuring him this should fix the problem, then he was put on Lovenox after a year when the clog got worst. Eventually the hematologist ordered a vascular test. And this lead to a PET scan to discover the cancer is now in Stage II and amputation or radiation is not an option due to the spread and resistant of the cancer. What can we expect if we contact MSK? At this stage, would it be worth it?

Dear Khany, we are sorry to hear about your cousin's diagnosis. If he is interested in making an appointment for a consultation with one of our specialists, please ask him to call our Physician Referral Service. The staff there can answer his questions and suggest the most appropriate expert for him to discuss his treatment options. The phone number for Physician Referral is 800-525-2225. Thank you for reaching out to us.

I have been diagnosed with stage 4 cancer of the esophagus. The cancer has speak to my liver, and one lymph node and a place in my stomach. What are my options? I live near Fort Worth Texas. I want to fight this but also been told there is no surgery to remove the cancer at its origin. Please let me know what your group may could do.
Thanks
John A

Hi John, to learn about MSK's approach to treating esophageal cancer, you can go to https://www.mskcc.org/cancer-care/types/esophageal/treatment. In some cases we are able to shrink large tumors enough to be able to remove them. We also have techniques for targeting individual metastatic tumors, including those to the liver. If you'd like to make an appointment, you can call 800-525-2225 during regular business hours or go to https://www.mskcc.org/cancer-care/types/esophageal/treatment for more information on making an appointment.

If you're unable to travel to New York City, you may want to go to https://www.cancer.gov/research/nci-role/cancer-centers for a list of National Cancer Institute-designated comprehensive cancer centers, to find one that is closer to where you live.

Best wishes to you, and thank you for your comment.

I have recently been diagnosed with uterine cancer and would like to know a good oncologist in my area to see? Live in central New Jersey.

Dear Lavina, we are sorry to hear about your diagnosis. If you would like to make an appointment with one of our specialists, please call our Physician Referral Service at 800-525-2225. You may be interested in asking our staff there about getting care at our Basking Ridge, NJ location (https://www.mskcc.org/locations/mskcc-basking-ridge), which may be more convenient for you. Thank you for reaching out to us.

On utz result there is a solid nodule at the right lobe of my liver,is that fatal,,and does it mean i have a cancer?

Dear Jen, we are sorry to hear about your health issues. We are unable to offer an opinion about whether or not you have cancer on our blog without more information about your medical history and the pathology of the mass. If you are interested in making an appointment with one of our specialists for a second opinion, please call our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

Can you recommend a good medical oncologist who just deals with people who have been diagnosed with stage 2 bile duct cancer and has the BRCA11 gene

i was recentally diagnosed with stage 3 breast cancer. no lymph node involvement. she said i was only stage 3 based on size ( 5 cm). i was never told if i had vascular invasion, nothing, and was not given a copy of my pathology report even after asking for one i was told no. i went to a breast surgeon, he said the tumor was ulcerated and cancer, and was having a mastectomy the next morning. no biopsy nothing prior. does this all seem normal? i refused chemo since it was not in nodes and the surgeon thought it was all contained. the oncologist made a snood remark about my decision and walked out. thoughts on these issues? thanks

Excellent tips for the first visit

Nabil, we are glad that you found the information in our blog helpful. Thank you for your comment!

Hi, my daughter is 16 and has been having leg tremors for about a year. They only occur once a month and has not had an episode since October. She has also lost 17 pounds in about 6 month period. All her. Look work is good . Her pediatrician and a Nero doctor seem to think she is fine and we should not worry because all her labs have come back normal. We are now being referred to an oncologist although she has not been diagnosed with any type of cancer. Should we be concerned or is she normal? How do we prepare ourselves for this appointment if she has not been diagnosed with anything?

Dear Laura,a we are sorry to hear about your daughter and everything she has been going through. Our best advice is to ask lots of questions and make sure the doctor is aware of all the symptoms and tests she's had to date. Hopefully the oncologist will be able to confirm whether or not she has cancer.

If your daughter is diagnosed with cancer and you would like to consider coming to MSK for care, please call our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

My 90 year old father had severe anemia and had CT scan which showed a 4cm tumor in his rectum. Given his age, his primary doctor does not recommend any further treatment, aware that my father is not open to surgery, even colonoscopy. Do we just settle with this plan?

Dear Elvie, we are sorry to hear about your father's diagnosis. If you would like to make an appointment with one of our specialists for a second opinion regarding possible treatment options, please contact our Physician Referral Service at 800-525-2225. Thank you for reaching out to us.

My 63 year old significant other, J, was diagnosed with Lymphoma yesterday. He is meeting with an oncologist today in Long Island. After this meeting, we would like to make an appointment for a second opinion at Sloan in NYC, which I assume can be done by calling the 800 number above. Is there a list available of the insurance that is accepted at Sloan?

Dear Joan, we're sorry to hear about your significant other's diagnosis. You can find information about insurance on our website here: https://www.mskcc.org/insurance-assistance/insurance-information

If you call our number at 800-525-2225, our experts there will be able to answer any questions you have about insurance.

Also, if he is interested in treatment on Long Island, you may want to consider our facility in Commack. You can find more information about it here: https://www.mskcc.org/locations/msk-commack Thank you for your comment, and best wishes to you.

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