Today, let’s talk about what are the best questions to ask your doctor if you are diagnosed with lung cancer?
The lack of medical resources in China, with too few doctors and too many patients, is a direct result of the short time between doctors and patients for each communication. In the United States, doctors see a few patients a day; in China, doctors see dozens or hundreds of patients a day. In the U.S., patients usually have a half hour to an hour to communicate and ask any questions they may have each time they see a doctor. In China, it’s usually only 5 minutes, which is a huge challenge for both sides.
This is not likely to change anytime soon, so what we need to do is improve the efficiency of patient-doctor communication, communicate the most important issues in a limited amount of time, and avoid wasting time. Some general questions, such as “Is there a cure or not?” and “Are you the best doctor for this?” It’s hard for doctors to answer, and whatever the answer is, it’s not really helpful.
So what are the best questions to ask if you are diagnosed with lung cancer? Here are 10 questions that are a good place to start.
(Image from Station Cool Helo)
What kind of lung cancer do you have?
First, you need to confirm the type of lung cancer based on pathology. For example, is it small cell lung cancer or non-small cell lung cancer? Is it adenocarcinoma or squamous carcinoma? Or is it some other type of lung cancer? This is one of the most important questions. There are many types of lung cancer, and pathological diagnosis is a prerequisite for all treatment options. Without pathological confirmation, even the best doctors will be at a loss.
What is the tumor stage?
Once you know the type, the next important piece of information is the staging. That is, from imaging tests, such as a chest CT, that show what stage the cancer is in, how malignant it is, and whether it has metastasized. Low-stage (early) lung cancer may only require surgery or radiation therapy, whereas high-stage (advanced) lung cancer usually requires systemic therapy, such as chemotherapy, targeted drugs, immune drugs, and so on.
What is the molecular pathological staging of the tumor?
In addition to traditional pathology, for lung cancer, it is important to know what the molecular pathological staging of the tumor is and whether it is a specific genetic mutation, such as EGFR, ALK, etc., that would allow the patient to use targeted drugs.
What is the purpose of the treatment?
Is it a radical treatment option or a palliative treatment option? There is a fundamental difference between radical treatment aimed at a cure and palliative treatment aimed at prolonging life and improving quality of life.
What are the specific options for treatment?
Does it require surgery only, radiation only, or surgery + radiation + chemotherapy together? Why did the physician choose this regimen? What are the superiorities? What is the impact on survival?
What is the approximate cost of treatment? Is it covered by health insurance?
The cost of cancer treatment varies widely among drugs and treatment options. Doctors often need to weigh the efficacy and cost of treatment against the patient’s financial situation to try to choose an optimal option. It is good news for patients that many expensive imported and domestic anticancer drugs have recently entered Medicare, including the lung cancer EGFR-targeting drugs Erythroxa, Troche and Kemena.
(Image from Station Cool Helo)
How should follow-up after treatment completion be scheduled?
Follow-up is very important for patients. In lung cancer, even in patients who are cured, there is still about a 30% chance that they will develop a second tumor in their lifetime. For patients who are not cured, follow-up is also important to improve quality of life. It is generally recommended to follow up once every 3 months after treatment, then once every 6 months after 2 to 3 years, and once a year after 5 years for life. The concept of follow-up is relatively lacking in Chinese patients, but it is very, very important.
What is the expected 5-year survival rate for patients?
What is the expected 5-year survival rate based on the type and stage of the cancer? If it is determined to be stage 4 advanced lung cancer, what is the 1-year or 2-year survival rate? Once you know the situation, patients and families can make appropriate arrangements for life and work. Chinese people are more shy about talking about death, but if it is acceptable to the patient and acceptable to the family, they are still expected to ask this question. Because everyone can be better prepared for the future.
Is it appropriate to use immunotherapy?
Immunotherapy for lung cancer is currently effective with PD1/PD-L1-based immune test point inhibitors. Research in this area is rapidly advancing, offering new hope to patients with advanced disease. In addition to treating advanced cancer, recent studies have found that immunotherapy can significantly control tumor progression and improve quality of life when used for inoperable stage 3 lung cancer patients. Lung cancer immunotherapies are not currently available in China, but there are potentially many clinical trials to participate in.
(Image from Station Cool Helo)
Any chance of a clinical trial?
A large number of novel anti-cancer drugs, whether they are targeted drugs, immune drugs or novel chemotherapy drugs, are in clinical trials in lung cancer, including in large hospitals in China. Clinical trials also have the particular advantage of free drugs and free testing. Therefore, if patients with advanced disease are resistant to standard therapies, they may want to investigate more clinical trial opportunities to see if there is a fit.