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Questions To Ask

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Subject: Questions to ask
Date: 01/14/2007

My mom who is 66 was just "diagnosed" with liver cancer, friday the 12th.  She is going to her oncologist on Wednesday.  We want to make sure we know what questions to ask when we get there.  Here is her history.

 

She has lost over 20 pounds in 4-6 weeks, is having diahrea, pains in liver area and stomach.  Protrusion along with overall swelling, bloating in stomach area.  Loss of appetite, foods no longer taste good.  After seeing her MD on friday, he sent her to clinic for CAT scan.  The doctor there basically said she has a large mass in her liver and fluid in the abdomen.  They drained fluid from her stomach, on the right side and sent some away for testing.  The doctor told my mother that it is most definately liver cancer. 

We basically do not know if it is primary liver cancer or secondary to some other cancer.  She did have breast cancer 12 years ago but has been fine and had good checkups every year since.  Normal blood counts and liver panels.

 Neither doctor mentioned surgery but the fact that it is large makes me think it may not be possible.

 

Anyway, if anyone could help us with information and any questions we may not think to ask, it would be much appreciated.  We know we need to start with the obvious of figuring out what type of liver cancer, etc.

 

Thanks much!

lisa 

Subject: RE: Questions to ask
Date: 01/16/2007

I've kept a long list of questions that I ask.  Some may not apply to you, because I had colon with mets to the liver

 You certainly don't have to ask all of these.  Some are more philathropic.  I did not include other curious questions I had, or questions from others about their cancers, that I asked him about.

 

Questions to ask when you first find out and before surgery.

Will I have PET scan?

A CT scan?

A PET/CT scan?

Will I need to have an ekg done? 

Will an angiography be done?

Will an anorectal ultrasound or endoscopic ultrasound be used.

Will I have an anesthesia interview?

Things that are good to know before surgery

It may be helpful to wash with an antibacteriol soap 1 week prior to surgery.

In either case, when would my liver be operated on?

Why do I need this surgery?

What will happen if I don't have it done?

What are the alternatives to surgery?

What are the risks of the surgery in the hands of a skilled practitioner?

What if they aren't skilled?

Is there an alternative or newer way to perform the surgery that offers different pros and cons?

If so, which method will you use and why? 

Any minimally invasive options?

Are those better?

Will the benefits be permanent? 

How long is permanent?

Besides here, where is the best place to have this done?

How many of these surgeries do you do a year?

How many does this hospital do a year?

How long will I be in the hospital?

Is it possible to do this on an outpatient basis, and is so, would that be the best scenerio?

Can this be done under local anesthesia instead of general?

How do your results in this operation compare with those of other surgeons?

What kinds of complications do your patient's most frequently experience from this surgery?

What should I do and not do immediately before and after surgery?

Find out about food, alcohol, medications, triathalons and other activities.

Is the operation painful? 

How much pain will I be in after surgery?

What painkillers will I be given during and after surgery?

(Get the drugs now and look them up, look up the side effects so you'll know what to look for, while you are still well)

How long will I be laid up after this surgery?

How soon will I be able to drive?

What kind of scar will I have? 

How long will it take to heal?

Is there anything I can do to minimize scaring?

How much time off from work will I need?

Will I need physical therapy?

For how long?

Will I see a Dietician?

What complications should I be on the lookout for after surgery and what should

I do if they occur?

Who should I call after my surgery if I have questions or if I experience something unexpected?

How long will I be in pain?

Where will my scar be?  Will the scar go away, or what can I do to help minimize scarring?

What symptoms or problems should I report right away?

What are the short term side effects? 

What are the long term side effects?

If I don’t feel sick, does that mean my treatment is not working?

Are the survival rates better for people if it’s in the blood and not in the lymph nodes?

How long will I experience side effects after the surgery?

How will you check to see if the treatment is working?

What should I eat after the surgery?

What type of exercises can I do, and when can I start?

What does my blood look like?  (I always get a copy of my blood test and chart it along with my CEA)

What about my liver enzymes?

How many lymph nodes were taken out? 

How many were positive?

What was my grade of Tumor?

When will I be done with chemo?

How long will the recovery take after each surgery?

Would taking Avastin help me?

Would taking an aspirin a day help me?

Why do some people get radiation therapy?

Would chewing gum be helpful?

Would walking be helpful?

What are the chances of the cancer come back? 

How often will you see me and for how long?

What kind of ongoing health needs will I have?                                                

Are there long term side effects of the treatment or disease that may occur?   

How often do they occur? When are they likely to occur?                                 

When do I start remission?                                                                         

Is there any harm to my veins from the IV’s?  I get bruises from them?

Can I see my CT scan?  Can I get a copy?

Can I see my MRI?  Can I get a copy?

Can I see my PET scan?  Can I get a copy? 

Can you see if I have heart disease or any other disorder?

How are my arteries?  Or should I have a cardiologist look at this for heart disease?

What does a PET scan do? 

How is a PET scan better than a CT scan?

What will the long term effects of getting CT scans or Pet scans be? 

What about MRI’s?

Would you recommend getting a whole body CT scan?  How often?

Would you recommend getting a whole body PET scan?  How often?

What types of tests do you get to ensure you’re in good health?

What magazines, journals or websites do you read to keep up to date on cancer or health in general? 

Are their any books you’d recommend?

Do you think it is odd that I only had # lymph node affected? 

Are my chances for survival better since it only affected this many?

Will I have future bladder, bowel problems with age?

Whom would you recommend to Mayo?

Whom would you recommend to M.D. Anderson Cancer Center?

What other hospitals would you recommend?

Have you had a colonoscopy?

Where did you go?  Who did you go see?

What are the chances that cancer spread during surgery?

What do I need to prepare for surgery?

When should my blood return to normal?

Anything I can do to speed it up?

What is your political affiliation?

Your religious denomination?

Are you for or against stem cell research?

What part of your job do you enjoy the most?

What part do you enjoy the least?  (It's good to know this, because if he's bad at counting how many chemo sessions you've had, you'll know that is what he'll need the most help in).

If you had surgery, what would you be most concerned about?

What would you make sure was in place or that was done to you?

Besides the Dr.’s credentials, what else would you look for?

What would you do to prepare yourself?

What types of surgeries have you had?

Who was your Doctor?  (And share the names with me.  That's how we can network and find out the good Dr.'s that other Dr.'s go to)

How did you pick that Doctor?

Do you take any vitamins or any stuff to keep you healthy?

Do you think there are any natural vitamins to keep you healthy?

If more lymph nodes were affected, would there be a greater chance of recurrence?

Have any outcomes surprised you?

Am I more susceptible to blood clots?

Is your chance of getting any cancer greater if you have a family history of cancer?

Does nuking things in plastic in the microwave cause cancer?

What about using saran wrap?

What about Teflon? 

What types of cooking pans do you use at home?

What other untrue rumors are there about cancer?

How much time, after surgery, is too late for chemo to be effective?

These are questions to ask if you're having a test.  Later if you're having surgery.

What does this test measure?

Why do I need it?

What could happen if I don't have the test?

Are there any alternatives to the test?

How accurate is the test?

How frequently does this test return false positives and false negatives?

How is the test performed?

What kind of pain or discomfort is involved?

What can go wrong?

How should I prepare for the test?

How will I feel after the test?

Can I return to work immediately?

When will I get the result?

Which lab is processing the test, and why did you choose that one? 

(Check to see if the lab is accredited by the Joint commission at www.jcaho.org or by the College of American Pathologists at www.cap.org)

What's the ideal result that I want to get on this test?

After taking the test and getting the results, what's the next step?

 

 

Subject: RE: Questions to ask
Date: 01/16/2007

Since you will get a lot of information, I record all of my meetings with my doctors, and then I transcribe them afterwards. 

This helped me so much, because although I take notes, sometimes you forget or don't write something down.  My friend and I both thought the Dr. said I wouldn't get any blood transfusions.  So I was surprised to find out I got one.  I went back and listened to the tape and sure enough he said I would get one. 

Don't rely on your or your friends memory.  Your under stress, record it.  Play it back.  My doctors words have been so comforting to me.

Let us know if you have any other questions.  I had half my liver cut out, so I have some idea about your surgery, but not much.  Your liver does regenerate, so don't be concerned about the surgery.  My liver is 95% of the size it was before.

 

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