Five things to know about oncology appointment

If you've been referred to a cancer specialist, you're probably about to face some big decisions.

Here's what you should know about your first meeting with an oncologist:

1TAKE YOUR

MEDICAL RECORDS

WITH YOU

Your official records should be sent directly from your doctor to your oncologist, but they don't always get there before you do, said Dr. Lora Weiselberg, chief of the Breast Cancer Service in the Don Monti Division of Medical Oncology at North Shore University Hospital and LIJ Medical Center and an associate professor of medicine at New York University School of Medicine. Because of this, she said, it's a good idea to get copies of your medical records from your doctors and hand-carry them to your first appointment.

"At a minimum, this includes all your pathology reports -- including previous biopsy reports, even if they were benign -- and radiology reports," Weiselberg said. "Many oncologists also want the actual X-ray films or discs of them, the pathology slides, genetic testing reports and notes about operations," she added. "The more information that is available at the time of the consultation," she noted, "the more complete a picture your oncologist will have and the more specific the recommendations will be."

Also take lists of all previous surgeries with dates, all medical conditions and how long you've had them, and all medications and supplements you're taking, Weiselberg suggested. "Just because something is touted as being 'natural' does not mean that it is not relevant," she said, explaining why a list of supplements can be crucial. "Some of those things may interact with your treatment or actually be harmful."

2IT'S SMART

TO TAKE

A FRIEND ALONG

It's entirely normal to be overwhelmed after a cancer diagnosis, and many patients find it a challenge to understand all the relevant details. That's why oncologists recommend you don't come alone to the appointment.

"It is an excellent idea to bring someone with you for the first visit," said Dr. Bhoomi Mehrotra, director of the Joel Finkelstein In-Patient Oncology Unit and Adult Bone Marrow Transplant Unit at Long Island Jewish Medical Center in New Hyde Park. "The accompanying individual doesn't have to be a relative. He or she could be a close friend, a neighbor, someone that the individual trusts." This person can help by taking notes, assisting with appointment scheduling and asking questions, Mehrotra said.

3DECIDE IN ADVANCE

WHAT YOU WANT

TO KNOW

Do you want to know your prognosis? Some people don't, said Dr. Eva Chalas, director of Clinical Cancer Services and chief of the Division of Gynecologic Oncology at Winthrop-University Hospital in Mineola. Some people "just assume that they're going to be cured," she said; whereas, others "don't want to talk about it because they know they would feel defeated if they knew what the prognosis was."

Chalas said she finds it helpful "if I tell them what they need to know -- the basics, here are some of the options, here are the side effects -- and then wait for the patients to ask questions."

4DEFINITELY ASK QUESTIONSJust what you should ask depends on the type of cancer and your personal situation. For instance, "if you would like to have children in the future, ask about the likelihood of treatment causing infertility," Weiselberg said. "If infertility is a possible effect of the treatment, ask about a referral to a specialist for fertility preservation. Although there are no guarantees, there are some steps that can increase the chance of future childbearing for both men and women with cancer."

Generally, though, cancer patients should ask:

What's the goal of the treatment -- to cure you or help reduce pain and keep you comfortable?

What are the side effects of treatments? How likely are they to occur?

Are there alternatives to the recommended treatment? And why did the oncologist choose the specific plan?

Are there any clinical trials that might be appropriate?

5DON'T EXPECT TO LEARN, OR REMEMBER,

EVERYTHING

AT THE FIRST APPOINTMENT

Learning about your cancer and possible treatments is an ongoing process that can take months or years, Chalas said. "People shouldn't expect to get everything, every nuance and bit of information, in the first meeting," she said. "You might absorb 20 percent, but you'll get the gist of what's going to happen."

Keep in mind that you'll learn more as you undergo treatment and talk to nurses, she said. "A lot of the day-to-day stuff -- the logistics of the treatment and what to eat and protecting yourself from the sun -- are addressed continuously," she said. "You ought to expect your oncologist to work with an experienced team of people who will usher you through this process."