MSK head and neck surgeon Marc Cohen (left) recommends asking your oncologist if you should have additional testing. In some cases, additional testing can help clarify a diagnosis or even guide treatment.
A cancer diagnosis is a life-changing event, one that can feel initially paralyzing: I have cancer, now what? The first step is to make an appointment with an oncologist, a doctor who specializes in treating cancer. Medical oncologists work with a patient and their care team to design a treatment plan that may include chemotherapy, surgery, radiation, immunotherapy, and other cancer-fighting drugs. Oncologists usually specialize in treating specific types of cancer.
It is easy to call or email Memorial Sloan Kettering Cancer Center (MSK) to make an appointment with an oncologist. MSK’s Patient Access Service (PAS), staffed by oncology nurses and other medical professionals, will help to set up your first visit. They will work with you to identify and make an appointment with the best oncologist for you. If you have been diagnosed with cancer — or have test results indicating that you might have cancer — it is important to see an oncologist as soon as possible. Depending on your situation, some people can even be seen at MSK the next day.
Because MSK diagnoses and treats more than 400 different types of cancers, we will have the right expert for you.
As PAS Medical Director, MSK surgeon Marc Cohen, MD, MPH, has guided many people and their families through their next steps after a cancer diagnosis. He says it’s a good idea to bring a list of questions to your first appointment. He also recommends bringing a loved one or friend. They can help you navigate paperwork and gather everything you’ll need for your first visit. During your appointment, they can take notes and make sure you ask all your questions and understand everything you’re being told. They can also lend support during an experience that may feel overwhelming.
Although each person’s experience with cancer is unique, Dr. Cohen suggests these questions to help you get started.
What type of cancer do I have, and what stage is it?
Dr. Cohen says it’s important that your doctor clearly explain the kind of cancer you have and how advanced it is. These factors help determine your treatment plan and may influence the outcome. Generally speaking, cancer that is stage 1 or 2 has not spread beyond the immediate area of the tumor. A cancer is often considered to be stage 3 when it has spread to the lymph nodes. Stage 4 means that the cancer has metastasized or spread to other organs, sometimes far from the site of the tumor.
At your first appointment, your doctor will ask about your medical history. It’s very easy to forget when things happened, so it’s helpful to write down the timeline of events to bring with you:
- What symptoms made you go to your doctor in the first place?
- What tests did your doctor order?
- Were you referred to additional specialists?
- Had you previously been treated for cancer?
Will you be able to find out what caused my cancer?
Cancer develops when a cell in the body begins growing without guidance from your DNA, like a runaway train that keeps accelerating. While there isn’t always a specific cause, studies have shown that diet, alcohol, smoking, and lack of exercise can increase a person’s cancer risk, as do known carcinogens in the environment, such as ultraviolet light. Some cancers are caused by inherited mutations in genes like the BRCA1 and BRCA2, which increase the risk of breast and other cancers, but most cancers are caused by genetic mutations that occur at random.
In some cases, MSK-IMPACT® — the tumor-sequencing test developed by MSK — can help find the cause of your cancer by identifying mutations in both inherited and random genes that are linked to specific cancers.
MSK offers programs that help patients quit tobacco, improve their eating habits, and increase their physical activity. Changing your lifestyle after a diagnosis may improve your outcome and minimize side effects from treatment.
Should I get a second opinion from an MSK pathologist? What about more tests?
Pathologists are doctors who specialize in diagnosing disease. Getting the right diagnosis from a pathologist is crucial. In some cases, a second opinion by an MSK pathologist may result in changes to the diagnosis.
The MSK Department of Pathology and Laboratory Medicine has 15 multidisciplinary teams dedicated to diagnosing specific cancers. All day and every day, their expert eyes are looking for cancer.
In many types of cancer, additional testing can help clarify the diagnosis or even guide the choice of treatments. The MSK-IMPACT® test looks for genetic vulnerabilities in cancer cells in the hope of matching patients with targeted drugs that can block the mutations that are causing cancer cell growth.
What experience do you have in treating my type of cancer?
MSK is one of the world’s most respected comprehensive centers devoted exclusively to cancer — our people are leading experts in their fields. Dr. Cohen suggests asking your doctor:
- How many years have you treated people with this type of cancer?
- How many people do you treat each year?
- How often do you see cases like mine?
When can I start treatment?
Most important is getting an accurate diagnosis and developing the right treatment plan for you. Oncologists may recommend tumor analysis and other tests to determine the best course of treatment. It may be possible to plan treatment around big life events, such as a child’s wedding or a long-planned trip. Ask your doctor about how urgently you need to begin treatment.
What are my treatment options?
At you first appointment with an oncologist, Dr. Cohen recommends beginning by asking: “What is the standard treatment for my cancer?”
Depending on the type and stage of your cancer, your treatment plan may include surgery, chemotherapy, radiation, immunotherapies, or other cancer-fighting drugs. MSK has been at the forefront of innovations in cancer treatment, from targeted therapy to immunotherapy to cancer vaccines. Doctors at MSK are also experts in cancer surgery, specializing in minimally invasive and robotic surgery, which can improve outcomes and recovery time.
What are the potential side effects of the treatment you recommend?
Side effects from cancer treatment can range from the mild to the significant and can have an impact on everything from daily routines to your ability to work. Dr. Cohen suggests talking to your oncologist about how potential side effects may impact your quality of life.
For patients planning on starting families or having more children, Dr. Cohen says it’s important to understand how treatment may impact future fertility and to ask your oncologist about fertility preservation before beginning treatment.
MSK offers integrative medicine to help patients cope with the physical and mental impact of cancer diagnosis and treatment. MSK’s Integrative Medicine Service empowers patients with evidence-based practices including acupuncture, meditation, and music therapy that fit seamlessly into your care plan.
What is the goal of treatment? How long will I be in active treatment?
Cancer treatment goals are based on each individual. For some patients, the treatment goal may be the elimination of disease, while for others the goal is the successful management of symptoms. At MSK, doctors work closely with patients to customize treatment with the goal of preserving your quality of life while offering the highest quality of care.
The length of treatment also varies depending on several factors, including how advanced a cancer is and how well treatments are working.
Where can I start treatment?
In addition to our main campus in Manhattan, the MSK Ralph Lauren Center in Harlem, and locations in Brooklyn, MSK offers treatment — including chemotherapy, radiation, and imaging — at several regional locations:
New Jersey
- Memorial Sloan Kettering Basking Ridge
- Memorial Sloan Kettering Bergen
- Memorial Sloan Kettering Monmouth
Long Island
- Memorial Sloan Kettering Commack Nonna’s Garden Foundation Center
- Memorial Sloan Kettering Nassau
- Memorial Sloan Kettering Skin Cancer Center Hauppauge
Westchester County
At MSK, all in-patient surgery is performed at the central campus in Manhattan. Outpatient surgery is available at MSK Monmouth.
MSK also routinely offers telehealth appointments, including for second opinions following a cancer diagnosis at another hospital.
Should I consider joining a clinical trial?
A clinical trial tests new treatments to see how well they work. MSK has one of the largest clinical trials programs for cancer in the United States. That means our patients may have access to new therapies before they’re available in other hospitals. You and your care team can discuss any clinical trials that might be right for you.
Will we talk about my prognosis (outcome) during my first appointment?
At your first appointment, you and your oncologist can discuss your projected outcome. But Dr. Cohen says it’s entirely up to you. Conversations about prognosis are complicated because each person is unique and responds differently to treatment. The statistics about the prognosis for your kind of cancer may not apply to you. Dr. Cohen says it’s more helpful to keep in mind that at MSK, we have many options at our disposal, and we’re going to do whatever we can to help you.
Where can I get more information about making and preparing for an appointment with a doctor at MSK?
Here are some helpful links:
- Learn more about your type of cancer.
- See how our physicians care for our patients.
- Make an appointment.
- Prepare for your first visit.
Summary: Key Questions to Ask an Oncologist During Your First Visit
- What type of cancer do I have, and what stage is it?
- What experience do you have in treating my type of cancer?
- What is the standard treatment for my cancer?
- What are my other treatment options?
- Should I get a second opinion or additional tests?
- When and where can I begin treatment?
- What are the potential side effects of the treatment you recommend?
- What is the goal of my treatment? How long will I be in active treatment?
- Should I consider joining a clinical trial?
