Eight questions to ask after a cancer diagnosis

It can be difficult to talk about cancer but unfortunately rates of most cancers are on the rise with 1 in 2 of us developing cancer in our lifetime and it’s important we are clued up. An estimated three million people in the UK are living with cancer and this number is expected to rise to 3.5 million by 2025 thanks to a multitude of factors including a growing and ageing population, lifestyle behaviours, better diagnostics and increasing public awareness. 

A cancer journey usually begins when you experience symptoms that are unusual for you, such as blood in your stools, a new lump or bump, unexplained weight loss or a cough that won’t shift. Your GP will ask you questions about your symptoms, general health, may conduct an examination and do some tests. You may be referred urgently to a specialist. Sometimes a potential cancer is picked up incidentally, during a routine check-up or during investigation for another illness.  

Each patient’s cancer journey looks different, but having the knowledge to ask the right questions is key to ensuring you are making informed choices and getting the best care for you and your loved ones. It’s really important to be honest with your doctor: sometimes, as medical experts, we may ask personal questions about symptoms or lifestyle habits which may seem intrusive. We are only asking these to help inform the correct diagnosis as quickly as possible and it’s important to share all relevant information. Remember, your doctor has heard it all before, that what you say is confidential, and there is nothing to be embarrassed about. 

Here are some of the most common questions and their answers.

How long do I have to wait for further investigation?

Quite often, that symptom usually turns out to be nothing serious, but if cancer is suspected, you will be put on the Two-Week Wait pathway, an NHS England initiative whereby you will be referred to a specialist and seen within two weeks. 

I’m booked in to see a cancer specialist. What happens now?

You should have a bit more time to talk through everything with your specialist. They will introduce themselves and their role in your care and repeat questions about your medical history as well as conducting an examination. You may have had tests during your urgent referral appointment. If the results are available, you may receive a cancer diagnosis on the spot. Otherwise, you could be referred for further tests or a biopsy, where they take a sample of the suspected cancer for testing.

What if I think my question is stupid?

When it comes to cancer, knowledge is power. Ask all the questions that pop up in your head. There is no such thing as a stupid question. Sometimes having lots of unknowns makes the anxiety worse. I often find that once patients and their families get more familiar with their treatment and routine, they cope much better. 

What are my treatment options?

Your doctor will offer the treatment option that is deemed best for you. It’s still important to consider the other options to ensure that you are making the best decision for you. For example, there may be a particular treatment with a high success rate, but it relies on regular visits to hospital, which might not work for you. In that case, another option with less hospital burden might be a better option. 

There are lots of misconceptions about clinical trials. They often give access to novel treatments which often end up becoming the new standard of care. You could access these treatments earlier as part of a clinical trial programme, so I would encourage you to ask about what clinical trials are open at your centre. 

What can I do to help my treatment?

Advancements in cancer care mean there are lots of treatment options available. But I always encourage patients to also look at their lifestyle too. It’s never too late to make some lifestyle changes. It’s important to try and maintain a regular eating pattern, particularly when treatments can affect appetite or cause nausea, as maintaining weight is an important factor in tolerating treatments. 

There’s evidence to support staying active during cancer treatments (even if that means just getting up and dressed and walking around the house). Exercise has been shown to help improve cancer-related fatigue as well as cancer outcomes. If you have unhealthy habits like smoking or drinking a lot of alcohol, it isn’t too late to look at reducing those, too. Patients often feel empowered when they take some control and keep themselves as healthy as possible during treatment. 

How long will the treatment last?

Some of the newer treatment options, such as immunotherapy, involve regular hospital visits for a number of years, whereas chemotherapy, for example, is usually given for a few months and then a break. It’s important to ask about the duration of treatment because it may mean making changes to your routine for the foreseeable future.  

What about side effects?

Your doctor will run through the most common or life-changing side effects when discussing treatment options, and again upon signing consent to treatment. But you may have concerns unique to your situation. You might be worried about losing your hair, whether you are going to be feeling very tired if you have a demanding job, or a family to look after. It’s a common misconception that all cancer treatments cause hair loss, and just asking this question could save you so much worry. 

Where can I get support?

It’s normal to struggle with a cancer diagnosis, but there are lots of support services that can help. While your doctor will hopefully discuss the psychological effect your cancer and treatment is having on you, the focus of the appointments often leans towards treatment, side effects or prognosis. There are other healthcare professionals available to talk to you about all the other bits. Whether that be your mental struggles, financial worries, advanced care planning and anything else worrying you. Please inquire about support available. 

Dr Jackson-Spence posts on Instagram as @drfrankiejs