Questions to Ask Your Doctor About Skin Cancer
A skin cancer diagnosis is the first step in the rest of your life as a patient. As a two time melanoma patient, I have gone through the "What do I need to ask my doctor?" more times than I can recall. Often, you can leave an appointment with all the answers you sought going in, and an entire list of new ones to research based on those answers. It doesn’t matter if it is your first appointment or fiftieth, each time there may be something new to discuss. So what should you be asking your physician?
What type of skin cancer is it?
Start with the basics. Be sure and understand the specific *type* of skin cancer you have. Not all skin cancers are the same, or are treated the same. Even within types, there are several variables (including location, depth, and proximity) that will determine your treatment plan.
Which stage is the cancer?
If you do have melanoma, don't panic (yet). It IS the most deadly form of skin cancer, but prognosis varies wildly depending on the thickness of the melanoma when it is discovered. If caught early, your chances of survival just went way up. If it's late-stage (clinical-speak for stage IIIB/IV) well, the road got tougher, but take solace in melanoma being at the forefront of immunotherapy treatments. Knowing the stage will directly impact what your options are.
What are the treatment options?
When discussing treatment possibilities, be sure to ask what is the current "standard of care" - the first (aka "frontline") treatment that the typical person with similar disease goes on. That's your starting point. Inquire what Plan B would be, if the first one doesn't work; even if Plan B changes down the line, knowing you have something to fall back on is both good practice AND mentally reassuring (at least, as reassured as a skin cancer patient can be).
Are there any new treatments being studied?
See what treatments are currently in trial. Understand that many oncologists may not know all up-and-coming drugs being tested, but they SHOULD be able to navigate trial options with you. Clinical trials are where medicinal advances happen; particularly now as melanoma is leading the path to an entirely different type of cancer treatment called immunotherapy. Including them in your treatment discussions ensures that all available options are being presented and considered during the decision-making process.
Which option would you suggest to your loved one?
One way to gain insight would be to ask the physician what THEY would do if it were their parent, spouse, child, or themselves with this diagnosis. It often allows doctors to speak frankly, and also helps you understand the "why" behind the decision they would make. Doctors, and especially oncologists, are very grounded on what has been proven. While this is a good thing, occasionally it ends up being a bit frustrating when all their medical experience is conveyed though the "this is what the latest data shows" filter.
How do I avoid recurrence?
The final question to ask is "How do I best keep this cancer from coming back?" Depending on your diagnosis, the question will be part of the post-treatment discussion that you should have before starting on ANY therapy. Particularly with melanoma, some treatments are based on mutation type, and can give different end results.
"Doc, what type of skin cancer do I have? What stage is it? What are the current care options, including clinical trials that are available? What are the follow ups or next steps after this treatment?" Four simple sentences, with potentially complex answers, that will allow you, the patient, to make the most informed decision on your care.
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