Preparing for Your First Doctor Office Visit
Preparing for Your First Doctor Visit
You'll have lots of questions about your oral, head, and neck cancer diagnosis, and you should. Getting the right answers can help eliminate confusion and reduce stress.
By Chris Iliades, MD
Medically Reviewed by Pat F. Bass III, MD, MPH
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Getting an oral, head, or neck cancer diagnosis can be stressful and confusing. In fact, studies show that after a cancer diagnosis people remember less than half of what their doctors say. In addition to preparing a list of questions, it's a good idea to bring along a family member or close friend to your first doctor visit.
Oral, head, and neck cancer usually requires a team approach for treatment and recovery. Gene Alford, MD, plastic and reconstructive surgeon at the Methodist Hospital in Houston, says the first question to ask your doctor is: "Do you participate in a tumor board or a multi-disciplinary cancer treatment team that has a medical oncologist, radiation oncologist, head and neck surgeon, facial plastic surgeon or plastic surgeon, a speech pathologist, surgical pathologist, social worker, nurses, and dentist or oral surgeon?"
"Head and neck cancer makes up only 3 percent of cancer diagnoses. You need a team of experts to treat it successfully, not someone who dabbles in head and neck cancer," says Guy Petruzzelli, MD, an ear, nose, and throat specialist at Saint Joseph Hospital in Chicago.
The Basic Questions After Oral, Head, and Neck Cancer Diagnosis
You'll have lots of questions to ask your doctor after a cancer diagnosis. It might be a good idea to have a loved one keep the list of questions and write down the answers.
Here are some basic questions:
- What is the stage of my cancer?
- What are my treatment options?
- What treatment option gives me the best chance of full recovery with the least loss of function?
- What are the risks and side effects of each treatment option?
Specific Questions After Oral, Head, and Neck Cancer Diagnosis
The types of cancer included under the umbrella of oral, head, and neck cancers include cancers of the larynx or voice box; salivary glands; nasal cavity (the air passage behind the nose) and paranasal sinus (small cavities surrounding the nose that humidify air you breather in); and nasopharyngeal (an area just behind the nose and going straight back toward the skull). So, depending on the diagnosis, you will have specific questions on the type of treatment you'll receive.
The types of treatment available are surgery, radiation therapy, and chemotherapy. Each brings its own set of questions:
Surgery.Cancer of the larynx or voice box, hypopharynx, and salivary glands are examples of head and neck cancers that may require specialized surgery. For cancer of the larynx, ask if your speech function can be saved. For salivary gland cancer, ask about the risk of nerve damage. If any surgery may cause loss of function or deformity, Dr. Alford suggests asking, "Is functional and cosmetic reconstruction an option available for me at the time of my tumor removal surgery?"
For head and neck cancer surgery, don't be afraid to ask your doctor how many of these surgeries he has done. "If your doctor doesn't do at least one a month, he probably shouldn't be doing it at all," says Dr. Petruzzelli.
X-ray treatment.X-ray treatment, or radiation therapy, may be the primary type of treatment for nasal cavity and paranasal sinus cancer and for nasopharyngeal cancer. "There have been tremendous advances in radiation therapy over the last 10 years. Intensity modulated radiation therapy, or IMRT, allows us to treat head and neck cancer much more effectively and with many fewer side effects than before," says Nisar Syed, MD, medical director of radiation oncology at Long Beach Memorial Medical Center in California.
If you will be treated with radiation for any head and neck cancer, "Ask if your radiation therapy center uses image-guided IMRT," Dr. Syed says.
Chemotherapy.Oral and pharyngeal head and neck cancers are usually treated with a combination of treatments that may include chemotherapy. The drug cetuximab (Erbitux) is just the first of a new kind of cancer drug recently approved by the Food and Drug Administration for head and neck cancers. Erbitux blocks the activity of a substance called epidermal growth factor, which is needed for some cancer cells to grow. Check to see if your doctor is familiar with these new drugs and if they might be useful in your treatment.
With a Cancer Diagnosis, Don't Be Afraid to Ask About Anything
"There is no such thing as a bad question," says Alford.
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