5 Questions Every Cancer Patient Should Ask Their Oncologist

When you’re diagnosed with cancer, you’ll face more medical decisions in a few weeks than most people make in a lifetime. The difference between good and excellent cancer care often comes down to one thing: asking the right questions.

This guide provides the essential questions every cancer patient should ask, and explains why each answer matters for your care.

Before we start: how to have effective conversations with your oncologist

Preparation tips:

• Write questions down before your appointment
• Bring someone with you to take notes (two sets of ears are better than one)
• Record the conversation (with permission, most doctors are fine with this)
• Request copies of all test results and reports
• Don’t apologize for asking questions, it’s your life

Question 1: “What is my exact diagnosis, including the type, stage, and grade of cancer?”

Why this matters

Your treatment plan depends entirely on your specific cancer characteristics. “Breast cancer” isn’t enough, you need details:

Cancer type examples:

• Breast cancer: Invasive ductal carcinoma vs. invasive lobular carcinoma vs. inflammatory breast cancer
• Lung cancer: Adenocarcinoma vs. squamous cell vs. small cell
• Lymphoma: Hodgkin vs. non-Hodgkin, and dozens of subtypes

Stage (0 to IV):

• Tells you how far cancer has spread
• Drives treatment decisions
• Stage 3 colon cancer and stage 4 colon cancer have very different treatments

Grade (1 to 3 or 4):

• How abnormal the cancer cells look under the microscope
• Higher grade usually means more aggressive growth
• Affects prognosis and treatment intensity

What to ask for

• “Can you write down the complete pathology diagnosis?”
• “What does this stage mean in practical terms?”
• “Is there any uncertainty in the diagnosis that requires additional testing?”

Red flag

If your doctor seems vague about your exact diagnosis or stage, this is a sign you may need a second opinion or additional testing.

Question 2: “What are ALL my treatment options, including the option of doing nothing?”

Why this matters

Oncologists sometimes present one recommended treatment without discussing alternatives. You deserve to know:

• Standard treatments (chemotherapy, surgery, radiation)
• Targeted therapies (if your cancer has specific markers)
• Immunotherapy (if your cancer type responds)
• Clinical trials (experimental treatments)
• Active surveillance (watching and waiting)
• No treatment (if treatment risks outweigh benefits)

Important: For many cancers, there are multiple equally effective options. Your oncologist’s recommendation may be based on their specialty or institutional preference, not necessarily what’s uniquely best for you.

Question 3: “What genetic testing or biomarker testing should be done on my tumor?”

Why this matters

Modern cancer treatment is increasingly personalized based on your tumor’s genetic profile. Testing should happen BEFORE starting treatment when possible.

Critical tests by cancer type

Breast cancer:

• ER/PR/HER2 status (determines hormone therapy and targeted therapy)
• Oncotype DX or similar (helps decide if chemotherapy is needed)
• BRCA1/2 testing (patient and tumor)

Lung cancer:

• EGFR mutations
• ALK rearrangements
• ROS1 rearrangements
• PD-L1 expression
• Comprehensive genomic profiling

Colon cancer:

• MSI/MMR status (determines immunotherapy eligibility)
• RAS mutations (determines biologic therapy options)
• BRAF mutations
• HER2 amplification

All advanced cancers:

• Consider comprehensive genomic profiling (tests hundreds of genes at once)
• Platforms: Foundation Medicine, Guardant360, Tempus, Caris

What to ask

• “Has my tumor been tested for all relevant biomarkers?”
• “Should we do comprehensive genomic profiling?”
• “Will these test results change my treatment options?”
• “How long will testing take, and can I start treatment while waiting?”

Warning

Starting treatment before complete testing is sometimes necessary (fast-growing cancers), but often patients begin chemotherapy before knowing they might benefit from targeted therapy or immunotherapy with fewer side effects. The breadth of relevant biomarkers, and the speed at which the list grows, is part of why we built an AI knowledge engine that scored 100% on the US Medical Licensing Exam before we let it touch a patient’s records.

Question 4: “What does success look like, and how will we measure it?”

Why this matters

Different treatments have different goals:

Curative intent:

• Goal: Eliminate all cancer
• Measurement: No evidence of disease (NED) on scans, normal tumor markers
• Example: Surgery for early-stage colon cancer

Life extension:

• Goal: Shrink or control cancer, extend survival
• Measurement: Progression-free survival, overall survival
• Example: Chemotherapy for metastatic cancer

Palliative / symptom control:

• Goal: Improve quality of life, manage symptoms
• Measurement: Pain levels, functional status, symptom burden
• Example: Radiation for bone metastases causing pain

Active surveillance:

• Goal: Avoid treatment side effects unless cancer progresses
• Measurement: Stable disease on monitoring
• Example: Watching small kidney tumors

What to ask

• “Is this treatment intended to cure my cancer or control it?”
• “What are the success rates for patients like me?”
• “How will we know if treatment is working?”
• “When will we do scans or other tests to check progress?”
• “What happens if this treatment doesn’t work?”

Question 5: “What are the side effects, and how will they impact my daily life?”

Why this matters

Treatment side effects can range from minor inconveniences to life-altering complications. You need realistic expectations:

Questions to ask about side effects

• “What side effects do most patients experience?”
• “What are the rare but serious side effects I should watch for?”
• “Will this treatment affect my ability to work?”
• “What about sexual function, fertility, and intimacy?”
• “Are the side effects temporary or permanent?”
• “How will we manage side effects if they occur?”
• “What should I do if I experience [specific side effect] at 2am on a weekend?”

Side effects often not discussed (but should be)

Cognitive effects (“chemo brain”):

• Memory problems
• Difficulty concentrating
• Can last months to years

Sexual and fertility effects:

• Erectile dysfunction
• Vaginal dryness or pain
• Infertility (discuss egg/sperm banking BEFORE treatment)
• Loss of libido

Appearance changes:

• Hair loss (head, eyebrows, eyelashes, body hair)
• Weight gain or loss
• Skin changes
• Scarring from surgery

Financial toxicity:

• Out-of-pocket costs
• Inability to work
• Travel costs for treatment

Emotional impact:

• Anxiety and depression (very common)
• PTSD symptoms
• Relationship strain

Important: Ask for written information about side effects. You won’t remember everything discussed in the appointment.

Quick reference: the five questions

What is my exact diagnosis, including the type, stage, and grade of cancer?

Ask for the specific cancer type and subtype (not just 'breast cancer' but the histology), the TNM stage, the tumor grade, and the result of any molecular or genetic markers. These details drive every downstream treatment decision and let you research evidence-based options that apply to your case.

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What are ALL my treatment options, including the option of doing nothing?

Ask the oncologist to list every reasonable option, including standard care, clinical trials, and watchful waiting. For each, ask about goals (cure vs. control), evidence quality, expected response rate, side effects, and the trade-offs. Request the option to do nothing or wait so you understand the natural history of your disease.

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What genetic testing or biomarker testing should be done on my tumor?

Many cancers have actionable biomarkers (EGFR, ALK, BRCA, PD-L1, microsatellite instability, tumor mutational burden, and more) that change which treatments are most likely to work. Ask which tests are recommended for your cancer type and whether results would change the treatment plan or open up clinical-trial options.

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What does success look like, and how will we measure it?

Ask about realistic outcomes: cure, remission, stable disease, or symptom control. Ask which imaging or lab values will track progress, how often they'll be repeated, and what would prompt a treatment change. Aligning on the definition of success up front prevents misaligned expectations later.

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What are the side effects, and how will they impact my daily life?

Ask for the most common side effects of each treatment, the serious-but-rare ones, how long they typically last, what can be done to manage them, and how they will affect your ability to work, drive, eat, sleep, and care for family. Request written side-effect information you can review at home.

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About Radical Health

We're building an AI nurse navigator that delivers personalized expert reports so every cancer patient gets clear, evidence-based answers about their case, regardless of where they live. Our AI platform analyzes over 10 million patient records and is overseen by oncologists from UCSF, MSK, UCLA, and Johns Hopkins. Learn more about AI-powered personalized reports at radicalhealth.ai.

Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with qualified healthcare providers about your specific diagnosis and treatment options.