8 questions to ask your gynaecological oncologist after a cancer diagnosis

Posted in gynaecological cancer, diagnosis, outlook; Posted 3 years ago by Andreas Obermair

If you are diagnosed with a gynaecological cancer, it is important to have all the information you require to make informed treatment decisions. Here are 8 key questions to ask your gynaecological oncologist after a cancer diagnosis.

1.    What is my tumour called and what is my prognosis? 

Your prognosis is the likely outcome of your cancer treatment. Prognosis is determined by your cancer type, location, stage, and the grade of the cancer. Your age, other medical conditions, any prior cancer treatment, and your overall health will also determine your prognosis. Sometimes, information on prognosis is only available once all the other information is known.

Your doctor may also refer to survival rates. Relative survival rates provide an estimate of what percentage of people with the same cancer are alive after the initial diagnosis of cancer, compared to healthy people of the same age and sex in the general population. Cancer survival statistics are frequently given in terms of 5-year timeframes.

Survival rates will not tell you how long you may live (this would be impossible to precisely predict) but can be used as an estimate of the successfulness of treatments. No two patients are the same, and treatment responses can vary.

2.    What are my treatment options, and which is right for me?

For most patients there are several treatment options available. Some options are reasonable and some are not. Treatment for gynaecological cancer will depend on its type, if it’s confined to the area it originated in, or if it has spread to other organs in the body. Treatments may include surgery, chemotherapy, radiation, hormonal therapy, or a combination of these.

Your gynaecological oncologist will present you with all the facts, may even recommend a treatment option for you and create a treatment plan for you. While the doctor can provide you with information, options and their recommendations, the ultimate decision on which treatment path to take is with the patient.

3.    Will I be able to become pregnant after treatment?

Depending on your age and personal circumstances fertility can be an important concern in your treatment plan. For example, if a total hysterectomy is recommended this will result in a loss to carry a baby yourself. Depending on your type and stage of cancer there are hormonal or surgical treatments available that can preserve your fertility. For early-stage cervical cancer, a radical trachelectomy is the treatment of choice for women who still require fertility. It involves removal of the cervix and the tissue next to the cervix (parametria). 

Ask your gynaecological oncologist about fertility-sparing treatments (and if they are available for your cancer type and stage) if you desire to preserve fertility.

4.    Who will provide my treatment?

Treatment of a gynaecological cancer can be complex and requires a cancer care team. The team is often led by medical practitioners and may include:

• A gynaecological oncologist who will oversee your cancer treatment. A gynaecological oncologist specialises in cancers of the female reproductive system; this is my speciality.
• Medical oncologist who administers chemotherapy, immunotherapy and other treatment drugs.
• Radiation oncologist who provides radiation therapy.
• In a public hospital setting, the hospital will assign a doctor to you. By contrast, in the private hospital setting you can choose your doctor and it is likely that your doctor will get to know you and provide care continuously.

Other health professionals involved in your care may include oncology nurses who will monitor your care and administer medication; allied health professionals, such as exercise physiologists, dieticians, genetic counsellors, clinical trial staff or mental health professionals to support your cancer journey.

Cancer Australia reports that a multidisciplinary team approach to cancer care can reduce mortality and improve quality of life for the patient.

5.    What side effects and inconveniences should I expect from treatment?

Depending on the cancer treatment received, this can cause side effects. Ask your doctor about the risks and possible side effects of each treatment offered to you. You should also ask how these risks can be reduced or managed.

Side effects may be short term that happen during or straight after treatment, such as recovery after an operation. There may also be long-term side effects which can occur months or years after treatment ends.

6.    I would like some time to decide my treatment plan. Will that make any difference?

Some gynaecological cancers are slow growing, while others can be more aggressive and therefore may spread more quickly. For fast growing cancer, the earlier the cancer is detected and treated, the better the health outcomes. For slow growing tumours, to rush is not of such advantage. Your doctor will advise when decisions should be made swiftly or when time can be taken to consider other options.

7.    Are there support groups I could join?

In my office, we can arrange contact between patients with their permission, and we can also do this for patients who require certain operations that do not involve cancer. It can greatly when you can share your experiences and ways of coping with someone in a similar situation as you. 

8.    Can I participate in a clinical trial?

Clinical trials aim to investigate if new treatments are safe and effective before they are made available as standard practice. Participating in a clinical trial may allow you to benefit from new treatments that could be less invasive, more effective and have less side effects than currently available treatments.

If you wish to take part in clinical trials, talk to your doctor about available trials that you may be eligible for and the potential risks and benefits of participation.

I discuss participating in clinical trials in more detail here.

These are just initial questions you may have and is not an exhaustive list. Cancer Council also provides an extensive list of questions to ask your doctor after a cancer diagnosis. When talking to your doctor it may be useful to write down a list of questions, take notes during the appointment or to bring a support person with you.

If you wish to receive regular information, resources, reassurance and inspiration for up-to-date care that is sound and in line with the latest research, please subscribe to my blog via the form above, or like Dr Andreas Obermair on Facebook.