Interviewing Your Oncologist

Choosing Your Team Leader ​

A Cancer Specialist such as a Thoracic Oncologist for lung cancer is more familiar with the latest diagnostic and treatment advances as well as with the latest promising treatment options for this very complex cancer type. You should strongly consider working with an Specialty Oncologist instead of a General Oncologist, and someone at a Facility which sees and treats many hundreds of lung cancer cases each year. You will usually find such Specialty Oncologists at Medical Teaching Institutions (see below).

A Thoracic Oncologist or disease focused Oncologist, may be more familiar and or may have access to more promising, possibly more effective approaches and treatment options for fighting your cancer. This cancer Specialist will confirm your diagnosis and order genomic testing. This Specialist and will then use that more detailed information to narrow your treatment options to those showing the most promise.

A Teaching Facility or Comprehensive Cancer Center may give you access to a broader range of treatment approaches that may not be available at smaller or local medical facilities. Clinical trials are often run through such centers, and offer a way to access new, promising treatments especially for more challenging mutations , aberrations.

One guide for identifying top tier medical, cancer facilities are those receiving the NCI’s “Comprehensive Cancer Center” designation. This is a prestigious designation that approximately 50 cancer treatment institutions have been awarded across the US. As an example, there are two accredited NCI cancer facilities located in the San Francisco Bay Area; UCSF and UC Davis Cancer Center in Sacramento. ADD LINKS HERE

Second Opinions

Meeting with several specialist Oncologists at different medical institutions through "Second Opinion" is advisable in order to gain different perspectives and assess the depth of their institutional experience in your cancer type. Getting a second opinion is commonplace, especially obtaining the opinion of a Specialist outside of your current medical facility. Medical institutions may vary in their philosophy and approach to treating various cancers especially if it is unusual or complicated. You could be given different approaches or options for treating your disease.

If you are reluctant to change your local Oncologist as your Lead, you can choose to have the Specialist (ie Thoracic) Oncologist as a periodic Second Opinion to advise your local Oncologist. If you do so, consult with this Cancer Specialist at critical decision points. The Specialty focused Oncologist will likely define your next treatment regimen as new treatment options or promising clinical trials might have become available. Your local Oncologist would consult and administer the treatment plan the Specialty (ie Thoracic) Oncologist defined locally.

Interviewing Oncologist(s) & Diagnostic Questions

1. What can you tell me about my type, subset of cancer? Is it unusual?

2. Please explain the staging of my cancer: T(X), L(X), M(X). What does this stage mean? What are the survival statistics for my disease stage?

3. What is the extent of your expertise in this specific cancer type?

4. How many other same cancer subtype patients are you presently seeing?

5. Do any of those patients have the same sub-type diagnosis and identical staging as me? How are they responding to treatment?

6. Will you request Comprehensive Genomic Profiling (GCP) to be conducted on my tumor tissue to identify my cancer mutation & immunotherapy sensitivity? (Physician can likely gain access to your non treated tumor tissue from your recent surgery, biopsy. )

7. Are you familiar with the Foundation Medicine, CDx test?

8. What are the most common cancer mutations for my disease?

9. What is your preferred method of treatment for this stage of my cancer?

10. Are there promising options to the current Standard of Care?

11. How do you define your treatment philosophy being at this medical teaching institution?

12. Are there early stage trials that might offer promising treatment options in the coming year or so?