What Are Some Questions
I Can Ask My Doctor?

As you cope with cancer and cancer treatment, we encourage you to have honest, open discussions with your doctor. Feel free to ask any question that's on your mind, no matter how small it might seem. Here are some questions you might want to ask. Print them and carry them with you during your next visit to the doctor. Be sure to add your own questions as well.

• Would you please write down the exact type of cancer I have?
• May I have a copy of my pathology report?
• What is the likelihood that the cancer has spread beyond my prostate? If so, is it still curable?
• What additional tests do you recommend and why?
• What is the clinical stage and grade of my cancer? What do those mean in my case?
• Is Brachytherapy a possible treatment option for me?
• What treatments might be appropriate for me? Why?
• Among those treatments, what are the risks or side effects I should expect?
• What are the chances that I will have problems with incontinence or impotence?
• What are the chances of the cancer coming back with the treatment you suggest?
• What is my expected survival rate based on clinical stage, grade, and various treatment options?
• Should I follow a special diet?

Questions about your initial evaluation and diagnosis

• What is my prostate specific antigen (PSA) value?
• Is my PSA value normal for my age?
• How does this PSA value compare to my PSA values in previous years?
• Should I have a repeat PSA value in a week or more?
• Did the digital rectal exam (DRE) feel in any way suspicious, and if so why?
• What do you recommend that we do next?

Questions about your follow-up examination

• What types of follow-up examination do you recommend, and what will be involved?
• Would there be any benefit to a free/total or prostate specific antigen (PSA II) test?
• Will you be doing a sextant biopsy with ultrasound guidance? (Sextant biopsy is usually guided by a transrectal ultrasound machine.)
• Will you be recommending a ProstaScint test? (ProstaScint test determines whether the cancer has remained local.)
• Will you be recommending a bone scan?
• Will you want me to have a CT scan or an MRI, and if so why?
• Would there be any benefit to using experimental tests such as reverse transcriptase polymerase chain reaction (RTPCR) in order to check for prostate cancer outside the prostate?

Questions about your diagnosis

• What is the diagnosis?
• What was the grade of the cancer?
• How much cancer in how many cores?
• What did the bone scan show?
• What did the CT scan or the MRI show?
• What is the clinical stage of the cancer and what do you think we should do?
• Do you believe that this cancer is organ-confined, or could it have spread to the lymph nodes?
• Do you believe this cancer is curable?
• Do you believe this cancer will spread if it is not treated -- and if so how fast?

Questions about treatment in general

• Is watchful waiting a reasonable course of action for me?
• What are the treatment options you believe are available to me?
• Do you believe radical surgery is appropriate in my case?
• Do you believe external beam radiation therapy is appropriate in my case?
• Do you think that brachytherapy or radioactive seed implantation may be appropriate in my case?
• Do you think that cryosurgery or other investigational techniques may be appropriate in my case?
• What form of treatment would you choose if you were in my shoes?
• Where would you go to seek that form of treatment?
• Who will actually operate on me if I elect to have a radical prostatectomy?
• Who will actually carry out the treatment if I elect to have radiation?
• How many radical prostatectomies do you do a year?
• How many [insert type of radiotherapy proposed] patients do you treat each year?
• Will resident physicians take part in the treatment? If so, what will they do, what is their experience, what is their specialty?
• How do you feel about neoadjuvant and adjuvant hormone treatment in association with surgery or radiation therapy? (Neoadjuvant hormone therapy is usually initiated 3 months prior to surgery or radiation. Adjuvant hormone therapy is given immediately following surgery or radiation.)

Questions about treatment effects and follow-up

• After treatment, what sort of problems should I expect and allow for?
• Should I expect problems related to bladder control, and if so for how long?
• Will I still be able to have a normal erection?
• Will I recover a normal erection after a period of time?
• If I have problems with incontinence or recovery of a normal erection, how long should I wait before we discuss the available treatment options?
• If the definitive treatment fails, and my PSA starts to rise again, what would you recommend at that stage?
• Do you believe in early or delayed hormone treatment for advanced prostate cancer?
• Do you believe that combined hormonal therapy offers benefits compared to surgical or medical castration for advanced prostate cancer?