Questions to Ask
Many men and their partners often find it difficult to know the kind of questions to ask their consultant or nurse specialist. We have listed some that we find are commonly in the minds of the newly diagnosed. We hope that this list will help you to realise the importance of asking for the information you want to know, and will give you the confidence to ask any that are important to you.
Work in partnership with your consultant
Let your consultant know if you want to work in partnership with him or her and be involved in the decision making; otherwise he or she may be unsure of how much involvement you want. The new NHS reforms clearly emphasise ‘NO DECISION ABOUT ME WITHOUT ME’ and strongly feature patient choice in where you want to be treated.
Your consultant should refer you to a nurse specialist (your keyworker), who should have more time to go into greater depth of detail about treatments and side effects. You should be given written material about the details of the most appropriate treatments for you before you leave. If you are not given any leaflets or booklets, you should ask for these. You cannot be expected to remember all you were told.
Try to list your questions before you go and take them with you, or you may wish to print them off. Write down the answers, so that you can refer to them at a later date. Try to take your partner or a friend with you to the consultation. It often helps. You may want to record the consultation; this is often possible with the agreement of your consultant.
Hospitals now adopt a multi-disciplinary team (MDT) approach to managing your treatment. A team would typically consist of a urologist, an oncologist, a pathologist, a radiologist and a urology nurse (see the Glossary of Terms). The team meets regularly to discuss all their patients. Each patient’s treatment is considered and approved by a range of senior clinicians, not just the doctor who happens to be facing the patient.
Some questions for your consultant
1. What is my Gleason score, and how is it split? (see The Gleason Score)
2. What T stage is my cancer? (see Staging of Prostate Cancer)
3. Is my PSA increasing abnormally? (see The PSA Test & DRE)
4. Can you tell me whether the cancer is fast or slow growing? (see Pussy-cats and Tigers)
5. As far as you know, is the cancer confined to my prostate?
6. What further tests do I need, and when will I have them? (see Further Tests for Prostate Cancer)
7. Is there a team and a Nurse Specialist managing my case? (see The Role of the Clinical Nurse Specialist)
8. What is the long-term situation for me? (You may prefer not to ask).
Treatment options and some general questions
1. What treatments are available for my type of cancer? (see Treatment Options)
2. What treatments would you recommend, and why?
3. What are the potential risks and benefits from these treatments?
4. Are any treatment options available elsewhere, which are not here?
5. If so, would this treatment be funded if I had to go elsewhere?
6. How quickly do I need to decide on treatment?
7. What are the possible side effects from the treatments? (see Side Effects)
8. Can anything be done to ease the side effects?
Three important questions for surgery
1. What type of surgery will I have – open, keyhole or robotic?
2. How many operations like this have you done, and what are your results?
3. Is it possible to have nerve-sparing surgery?
Three important questions for radiotherapy
1. Will I be able to have IMRT or IGRT radiotherapy?
2. What dosage will I receive, and over how many weeks?
3. Do I need hormone therapy as well? If not, why not?
Three important questions for hormone treatment
1. Do I need to have a bone density scan? (see Bone Health)
2. Will you recommend intermittent hormone therapy if necessary?
3. What drugs can I have to ease any side effects?
1. Are there any clinical trials or research being done for my stage?
2. Would I be a suitable candidate? (see Trials for Prostate Cancer)
1. Can I see my oncologist/urologist and specialist nurse? (see The Role of the Clinical Nurse Specialist)
2. Can I do anything to help myself with diet and supplements? (see Diet and Lifestyle)
3. Can you give me details of any local support groups? (see Find a support group near you)