Talking to Your Doctor(s)
Last Revised May 15, 1997.
Introduction |
Questions patients ask their doctors
In Part II
The six laws of patient-physician communication |
About time
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Introduction
This section is going to include personal opinions which cannot be substantiated by scientific data or
clinical trials. Some people may want to know more about the person who wrote these personal
opinions. If you are one of those people, feel free to click here.
Questions patients ask their doctor(s)
There are literally hundreds of questions which a patient might ask his
physician during the course of
evaluation and treatment of prostate cancer. What follows is just a small
sample of those questions.
You need to remember that almost any question is a reasonable one if it is
politely asked and if you
are listening to the answer. However, it is also worth bearing in mind
that there are some questions
you may not want to ask if you are not sure you are ready to deal with all
of the possible answers.
Questions about your initial evaluation and diagnosis
- What is my PSA value?
- Is my PSA value normal for my age?
- How does this PSA value compare to my PSA values in previous years?
- Should I have a repeat PSA value in a week or more?
- Did the DRE feel in any way suspicious, and if so why?
- What do you recommend that we do next?
- What would you do next if you were sitting here in my shoes?
Questions about your follow-up examination
- What types of follow-up examination do you recommend, and what will be
involved?
- Would there be any benefit to a free/total or PSA II test?
- Will you be doing a sextant biopsy with ultrasound guidance?
- Will you be recommending a ProstaScint test?
- Will you be recommending a bone scan?
- Will you want me to have a CT scan or an MRI, and if so why?
- Would there be any benefit to using experimental tests such as RTPCR
in order to check for prostate cancer outside the prostate?
Questions about your diagnosis
- What is the diagnosis?
- What was the grade of the cancer?
- How much cancer in how many cores?
- What did the bone scan show?
- What did the CT scan or the MRI show?
- What is the clinical stage of the cancer and what do you think
we should do?
- Do you believe that this cancer is organ-confined, or could it
have spread to the lymph
nodes?
- Do you believe this cancer is curable?
- Do you believe this cancer will spread if it is not treated -- and
if so how fast?
Questions about treatment in general
- Is watchful waiting a reasonable course of action for me?
- What are the treatment options you believe are available to me?
- Do you believe radical surgery is appropriate in my case?
- Do you believe external beam radiation therapy is appropriate in my case?
- Do you think that brachytherapy or radioactive seed implantation may
be appropriate in my case?
- Do you think that cryosurgery or other investigational techniques
may be appropriate in my
case?
- What form of treatment would you choose if you were in my shoes?
- Where would you go to seek that form of treatment?
- Who will actually operate on me if I elect to have a radical prostatectomy?
- Who will actually carry out the treatment if I elect to have radiation?
- How many radical prostatectomies do you do a year?
- How many [insert type of radiotherapy proposed] patients do you treat each year?
- Will resident physicians take part in the treatment? If so, what will they do, what is their
experience, what is their specialty?
- How do you feel about neoadjuvant and adjuvant hormone treatment in association with surgery or
radiation therapy? (Neoadjuvant hormone therapy is usually initiated 3 months prior to surgery or
radiation. Adjuvant hormone therapy is given immediately following surgery or radiation.)
Questions about treatment effects and follow-up
- After treatment, what sort of problems should I expect and allow for?
- Should I expect problems related to bladder control, and if so for how long?
- Will I still be able to have a normal erection?
- Will I recover a normal erection after a period of time?
- If I have problems with incontinence or recovery of a normal erection,
how long should I wait
before we discuss the available treatment options?
- If the definitive treatment fails, and my PSA starts to rise again,
what would you recommend at
that stage?
- Do you believe in early or delayed hormone treatment for advanced
prostate cancer?
- Do you believe that combined hormonal therapy offers benefits compared
to surgical or medical
castration for advanced prostate cancer?
As stated previously, the questions listed above are not intended as a
list of every question you might
want to ask -- they are just a guide. As you learn about your particular
condition, you will discover
questions of your own that are very specific to your condition and
treatment.
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