Questions for Evaluating Cancer Treatments and Providers
By Jeannine Walston
Inform yourself about options for your situation related to cancer. These questions do not apply to all cancer patients, treatments, as well as cancer practitioners and providers. Some of them are more appropriate, while others are not, including related to conventional, integrative, holistic, complementary, and/or alternative treatments. Take the time up front to think through these categories, and ask questions toward a fully informed decision.
Make a list of questions in preparation for your consultations, take notes, record the appointments, and get reports from the appointment. Additionally, be aware that claims about curing cancer of practitioners and/or providers must be clearly explained in the dialogue together.
1. Treatments, Efficacy, and Safety
1. What are the conventional cancer treatment options for your grade and stage of cancer? What is being recommended for you? What cancer clinical trials are available?
2. What are the integrative cancer treatment options? What is being recommended for you?
3. What treatments would the provider choose for themselves or a loved one?
4. What evidence exists regarding the potential efficacy of recommended treatments?
5. What are the predicted outcomes with and without treatments?
6. In the provider’s experience with your diagnosis, what is the average time to response and specific types and length of disease response, including stable disease, partial response, and complete response? How does the practitioner define each of those terms?
7. How long will the treatments last? How often are procedures required? Will the provider create a treatment plan for the entire length of therapy?
8. Will treatments occur in a hospital, clinic, or self-administered at home?
9. What will team members be involved in your care? What are their roles?
10. How are patient progress and response rates monitored over time? What tests are recommended, and how often?
11. What is the safety profile?
12. What risks are associated with treatments?
13. How does the provider define the ratio between potential risks and benefits of treatments?
14. What is the impact of treatments on quality of life? How do the treatments impact day-to-day activities?
15. What short and long term side effects are associated with cancer treatments?
16. How are side effects such as pain controlled and managed?
17. Do the treatments cause changes in sexual function and/or fertility?
18. What can be done to support your body during and after treatments?
19. Is it possible to get secondary cancer from the treatments?
20. Is it possible that your type of cancer will spread due to the treatments?
2. Quality of Evidence Related to Cancer Studies
1. What have scientific articles been published about the treatments being recommended?
2. What is the scientific basis and history of the treatments?
3. Has the provider published scientific articles related to the treatments?
4. What is the experimental nature of the treatments, if any?
5. If the provider is using experimental therapies and conducting research, have they published their results, and if not, why?
6. Do studies exist about the cancer treatments independent of the provider and health care facility?
7. Who has funded studies evaluating the treatments?
8. Have any studies been published in quality journals?
3. Qualifications and Experience
1. How many people has the provider treated with your diagnosis? How many people have they treated overall throughout their careers?
2. What is the provider’s degree, and from what institution? What are their credentials, such as board certification of a specialty and subspeciality?
3. How long have they been in their current practice? What is their professional history before their current position?
4. Do they have a teaching appointment at a medical school, and if so, where and instructing on what topic?
5. Do they conduct research, and if so, what types of research?
6. What professional societies do they affiliate within, including past and current at this time?
7. Who do they collaborate within their field? Who is a part of their professional network? Is their network based in the country where they are practicing or elsewhere? Are the members of their network working more inside of outside of the provider’s discipline?
8. What compelled the provider to gain expertise in their discipline?
9. What discoveries throughout the provider’s career have informed their current regimen?
4. Integrity, Consistency, and Reliability
1. What is the provider’s bedside manner?
2. How do they communicate?
3. How do they sound?
4. What are their ethics and values?
5. Do they seem rational?
6. Do they seem honest?
7. Is what they say and do consistent?
8. Do they present themselves as a whole person in their role as a health care provider?
9. Is their clinical model fixed or evolving?
10. If their model is evolving, are the changes sensible or whimsical, erratic behavior? Do any capricious, unpredictable changes reflect the provider’s confusion and desire to experiment on patients?
11. Do they walk their talk?
12. Are they available to patients outside of appointment times for emergencies?
5. Personalized Medicine
1. Does the provider have a one-size-fits-all approach?
2. Do they see each patient as an individual?
3. Are they making any recommendations based on general knowledge versus insights about you as an individual?
4. Is the attitude my way or the highway in their practice?
5. If relevant, are they making any recommendations based on their own health experiences?
6. Integrative Care Care
1. What is the provider’s knowledge base about integrative cancer care?
2. What integrative cancer care plan are they recommending for you, if any?
3. If the provider is not integrative, do they have experience in working with patients who are using integrative approaches?
4. Does the provider ask you about all of the integrative cancer therapies you are using? Are they fostering a patient-centered conversation on the topic?
5. Does the provider know about and plan therapies so that they integrate with and optimize any conventional treatments?
6. If the provider is prescribing herbs, do they have a knowledge base and continue studying emerging scientific evidence about herb/drug interactions and incorporate that knowledge into patient recommendations?
7. Success
1. What are the provider’s measurements of success?
2. What is the provider’s definition of treatment success?
3. How does the provider’s definition of treatment success compare to your definition of treatment success?
4. What are the characteristics of patients that respond to therapies?