Introduction

You must be able to talk with your doctor so that your needs are met.

Cancer treatment often means that you will have more than one doctor. You may even have a team of doctors, nurses, and other people involved in your care. Although you may get information from several people, it's a good idea to choose one doctor to be the one you turn to with your questions. This doctor may or may not be the one you see most often. You should be the one to make this choice. We offer the following information to help you make the choice that’s right for you.

You should feel at ease with your doctor. Sometimes, it takes a little time and work before you feel at ease. You will want to take the time to ask your questions and make your concerns known. Likewise, your doctor must take the time to answer your questions and listen to your concerns. If you and your doctor feel the same way about sharing information, and making choices, you probably have a good relationship.

What is the first step toward feeling comfortable talking with your doctor?

Ask Yourself, “How Much Do I Want to Know?”

You may want to know a lot of medical details about your illness. Some people feel more in control of what is happening to them when they know all of the facts. Decide how much detail about your diagnosis and treatment would be helpful, and let your doctor know.

You may want only small amounts of information. It disturbs some people to be told too many details. They may want simple directions -- what pill to take or what their treatment will be and when it will be done. They feel overwhelmed by medical details and would rather leave most decisions to the doctor. Don't be afraid to tell your doctor how much or how little information you want.

Sharing Information

Everyone has a different style of sharing information. That's why the perfect doctor for one person may not be a good match for another. Think about what you value in a doctor. Some people feel want a doctor who will share information in a clinical and business-like manner. They expect their doctor to be the medical expert rather than a friend. Other people want their doctors to have an excellent "bedside manner." They value a doctor who can address both their emotional health and medical needs. Many people whose illnesses require treatment over a long period of time prefer this kind of friendly relationship with their doctor. After you have thought through what you want as a patient, the next step is to look at how you talk with the doctor you have chosen.

Remembering What Your Doctor Says

It's hard to understand complex information when you are anxious or afraid. Even if the doctor is thorough, you may not hear or remember what is being said. There are several ways to make sure you remember everything your doctor tells you. Decide which way will be best for you.

Take notes to help you recall what your doctor says.

• Ask if you can tape record your talk for later review.

• Have a family member or friend there with you. He or she can remind you of questions you want to ask and help you remember later what the doctor said. It may also be easier to have this person talk to your family about your medical status. This will help your family feel included without your having to deal with many questions. You may want their help in making decisions; so keeping them up-to-date may be in your best interest.

Sometimes, without realizing it, doctors use terms their patients don’t understand. If you don't understand something, ask your doctor to explain it to you.

Asking Questions

Here are some questions your doctor can usually answer for you:

• What is my diagnosis? What do I have?
• What treatment do you recommend?
• Are there other treatments?
• What are the benefits of these treatments?
• What are the risks?
• What medicines are you giving me? What are they for?
• How should I expect to feel during treatment?
• What side effects, if any, can I expect to have?
• What can be done about the side effects?

When you get instructions from your doctor, write them down. Make sure you understand them before you leave the office. Then follow them exactly. You may also want to keep written notes on any health questions and concerns. Bring your notes with you to appointments to help you remember what you wanted to ask or tell your doctor.

Here are other issues you may want to discuss with your doctor:

• Who else gets information about me? Should my spouse, my friends, or another doctor also get information? Think about your choices and tell your doctor what you want.

• What issues are important to me? For example, will the disease or the treatment keep me from working, or from caring for my family? Will I have any physical problems? Again, ask your doctor if you want more information about your treatment. Ask if there is written information you can take with you.

• If you have feelings of sadness or hopelessness that don't go away, mention this to your doctor. You may have clinical depression, an illness that can occur along with cancer. It can be treated.

• What is the best time to call if I have a question? Some doctors have a special time to return calls. Expect your doctor to call you back, but remember that a quick response may not be possible if another patient is having a crisis.

Above all, your doctor should take your questions seriously. He or she should be interested in your concerns and not make you feel rushed. If your doctor does not respond this way, bring it up at your next visit.

The Doctor-Patient Relationship

A good doctor-patient relationship is a two-way street. Here are some ways you can help maintain your end of the relationship:

• Tell your doctor about any changes in body functions -- from sleep and bowel habits to headaches. Make notes so you can report these accurately to your doctor.

• Discuss your concerns about how cancer will affect your lifestyle. Be honest about your habits -- even if they're habits, such as smoking, that you're not proud of. Never hold back information. Something you think is minor could affect your treatment. Or something you think is serious might be easily relieved.

• Make a list of all your questions, and take it with you to your doctor visits. Don't be ashamed or shy about asking these questions. There is no such thing as a "dumb" question. Refer to the list of questions above for some ideas, and then add your own.

If You Have a Problem Talking With Your Doctor

If you have a problem talking with your doctor, there are often ways to improve the situation. Try working out your concerns before deciding the situation is hopeless.

First, state your concern as honestly and openly as possible. Here are some opening statements you may want to consider:

• "I’m concerned that we aren’t communicating well, and here’s why ..."

• "I need to be able to talk with you about _________, and I feel like I can’t. Can we discuss this?"

• "I realize that you’re very busy, but I need to discuss _________ with you. Can we schedule a time to do that?"

• "I’m having trouble understanding ___________. Can you help me?"

If you need more details after your doctor answers a question, say so. Sometimes it's even helpful to ask the same question again in a different way. Unless you tell your doctor that you don’t understand something, he or she will usually assume that you do. There’s nothing wrong with telling your doctor that you don't understand. If you want to learn more about your cancer treatment, ask your doctor to suggest some reading materials. Learning more about your treatment can help you become more actively involved in it.

If you are unable to work out the problem during regular visits with your doctor, ask for a special visit to discuss it. If the issue concerns your cancer treatment, go to the meeting with as much information as possible. You can call us at 1-(800) ACS-2345 or visit us on our Web site at www.cancer.org for more information about cancer. Always tell your doctor where you get your information and then ask for his or her opinion.

Even if you feel frustrated or angry, try to avoid being hostile toward your doctor. Often people become defensive and withdraw when they feel attacked -- a response that will be unhelpful in the long run. State your concerns and questions clearly and honestly, without accusations.

What should you do if you feel you have done your part but the situation has not improved? You might consider talking with a third party about the problem. The head nurse or your family doctor might be willing to discuss the matter with the doctor. Sometimes this is less stressful than facing the doctor directly, and their help could improve the situation.

If not, it may be time to find a new doctor. Don't stay with a doctor only to protect his or her feelings. Just because you were referred to the doctor does not mean you can't decide to change on your own. It's your body and you have the right to find the best doctor for you.

Changes in the Doctor-Patient Relationship

If you are in the hospital, your relationship with your doctor will change somewhat. Many other people will be involved in your care during your stay at the hospital. Your doctor may not be the only one making treatment decisions.

Sometimes hospital policies and routines clash with your own, and will take some adjustment on your part. In the hospital, you will also be surrounded by activity, which can be stressful in itself. Keep in mind that your doctor may be able to help you solve problems that might come up as you adjust to hospital routines and practices.

If you have a problem with your doctor while you are in the hospital, there are other people who may be able to help. Speak to a nurse or a social worker, or ask if the hospital has a patient service representative on staff. They can provide support and help you organize your thoughts before talking with your doctor. With your permission, they might even speak directly with your doctor.

People who have cancer are likely to want to build a good relationship with their doctors. Building this relationship doesn't just happen -- it takes care and effort on both sides. Chances are you'll both benefit from it.

Revised: 04/06/2006