The Doctor-Patient Relationship

You rely on your doctor to give you clear and helpful information that will guide you through making decisions about your care. Your doctor relies on you to be open and honest, and to trust them. In this way, you and your doctor are collaborators – a team working together to make sure you get the best care possible.

Because good communication is key to being part of a collaborating team, it’s important to feel at ease with your doctor. How well you are able to talk with your doctor is a key part of getting the care that’s best for you.

Remember everyone is different

It can take time to plan and make treatment decisions when you have cancer. It's important to learn all you can. But, it's also important to remember that each person's cancer experience is different. There are many different types of cancer and subtypes of tumors that make a person's experience and treatment options different from someone else's. There are also other non-cancer health problems and factors that can affect how cancer care and treatment might be planned and given.

While there are many resources for information, your first and foremost resource should be your doctor and others who are part of your cancer care team because they know your situation best.

Taking an active role

Being a partner in your cancer treatment can help you get the best care from the team of doctors, nurses, and other health care providers taking care of you. By taking an active role, you show you are willing to talk with and consider the advice of the cancer care team members. It's important to remember that each team member has different skills that could help you make decisions. They can answer your questions, support you and your family, and help you feel that you have the information you need to make the decisions that are right for you. Also, your cancer care team members can help you find people and places near you that can give you more help, if needed. You can read more about people who may be part of cancer care teams in Health Professionals Associated with Cancer Care.

It’s also important to discuss your concerns about how cancer will affect your life and the things you do. Never hold back information. Be honest about your habits, even if they are habits you’d rather not talk about. This means you should tell your doctor everything, even things you're not proud of, like smoking, drinking, or using illegal substances.

How much do I want to know?

Deciding how much you want to know about the cancer and its treatment is the first step in being able to talk comfortably with your doctor and the rest of your cancer care team.

You may want to discuss everything about the cancer. Some people feel more in control about what’s happening to them when they know all of the facts. They try to fully understand their cancer, their treatments, and what they can expect.

Maybe you just want small bits of information at a time. Some people get upset when they are given too many details at once. They feel overwhelmed by medical details and would rather leave most decisions to the doctor.

Don’t be afraid to tell your doctor how much or how little you want to learn. When you let people on your cancer care team know how much detail you want to hear, they can communicate with you in the way that makes it best for you to absorb it and understand it.

Talking with your doctor isn’t always easy, but it's important to remember that your doctor is often the only person who can answer certain questions.

Giving and getting information

Each doctor has their own way of helping patients learn about cancer and cancer treatment. Some doctors and patients are better listeners than others. That’s why the perfect doctor for one person may not be a good match for another. The most important thing to remember is that you can ask members of your team for information any time you need to; if you are concerned, ask. They are there to answer your questions, even if you want to ask the same question many times. Good communication is the key.

Remembering what the doctor says

It’s hard to remember all of the things you’re told at each doctor’s visit, especially when you’re anxious or afraid.

Even if the doctor carefully explains things, you might not hear or remember all that’s said or shown to you. Here are some ways to help you remember everything your doctor tells you.

• Take notes on what your doctor says.
• Ask if you can record your talks.
• Take a family member or friend with you. Ask them to remind you of questions you want to ask and ask them to take notes, so you can focus on listening and talking directly with the doctor.

Make sure you understand any instructions you’ve been given before you leave the office.

If you have questions between doctor visits, write them down as they come up. Keep a notebook to help you stay organized. Remember that other members of your cancer care team can answer many of your questions, too.

If you need more details after your doctor has answered a question, say so. Sometimes it’s even helpful to ask the same question again in a different way. There’s nothing wrong with telling your doctor that you don’t understand. If you want to learn more about the cancer or your cancer treatment, ask your doctor to suggest some reading materials or trusted websites.

Basic information

Don’t be ashamed or shy about asking questions. There’s no such thing as a “dumb” question. Here are some basic questions that could help you talk to your doctor and start learning about cancer and the choices you’ll have to make.

Learn about more specific questions you might want to ask based on where you are in your diagnosis and treatment planning in Making Decisions and Managing Your Treatment.

• What type of cancer do I have? (What is my diagnosis?) You may want to ask them to write it down for you.
• What parts of my body are affected by my cancer?
• What is my cancer’s stage? What does staging mean? What does it mean for me?
• What treatment do you recommend and why?
• Are there other possible treatments?
• What are the benefits of these treatments?
• What are the risks?
• Do you have experience managing patients getting these treatments?
• How soon do I need to start treatment?
• How long will I need treatment?
• What medicines or other treatment will I get? What are they for?
• How should I expect to feel during treatment?
• What side effects, if any, can I expect to have?
• What can be done about the side effects?
• Can I work during treatment?
• Will I be able to have children after treatment?

Other things you might want to ask

Here are some other things you may want to talk with your doctor about:

Contact numbers

What’s the best time to call if I have a question? Some doctors have a special time to return calls. Many times a nurse or other member of your cancer care team can answer your questions, too.

Emergency contact numbers

Who and where do I call if I have a serious problem? What are examples of serious problems I should call about? When can a problem wait until the next day?

What about after office hours, on holidays, or on weekends?

Be sure you know how to get help any time you might need it. Ask your doctor what changes you should call about during office hours and which ones would need an emergency call during times when the office is closed.

Your medical information

Who else gets information about my health? Do my other doctors need to know about my cancer? You may also want your doctor to talk to your spouse, family members, or loved ones about your illness. You will probably be asked to sign a form giving your doctor the go-ahead to talk to certain people.

Getting a second opinion

When you’re facing cancer treatment, it’s normal to wonder if another doctor might offer a different treatment. Getting a second opinion can help you feel more sure about your diagnosis and treatment plan. Your doctor can help you find another doctor and/or get together the information you need to get a second opinion. Your doctor will not be surprised if you say that you would like to get another opinion, so don't be worried about telling your doctor if you'd like one. Sometimes, though, it's important to start treatment quickly and you might not have much time to get another opinion. Learn more in When Treatment Should Start and Seeking a Second Opinion.

Advance directives

If you have an advance directive or living will, be sure your doctor has a copy. If you don’t have them, your doctor can talk to you about how to create a legal document that contains instructions on the care you want if you become unable to make decisions for yourself. Learn more in Advance Directives.

Side effects

Ask your doctor what problems you should watch for and always tell your doctor or another member of your cancer care team about any side effects that you have. Physical symptoms can be very important for your doctor to know about during (and even after) treatment. People with cancer may have trouble with pain, breathing, sleeping, nausea, appetite, their bowels, feeling tired, or other problems. You might also have emotional feelings that are hard to manage at times, and you should tell your doctor about them as well. Remember your cancer care team can't help you with a problem if they don't know about it. Tell the doctor:

• What kind of problem (symptom) you are having
• The time of day you notice the symptom
• How bad it is
• Where you feel it in your body
• How long it lasts
• What, if anything, makes it better or worse
• How does it affect your daily life

If you keep having side effects after being treated for them, let your doctor know what works and what doesn’t. Many people have to try more than one way to get side effects under control.

If you feel sad, overwhelmed, or hopeless a lot of the time and these feelings don’t go away, tell your doctor. There are many kinds of emotional distress that go with cancer and its treatment. See Emotional, Mental Health, and Mood Changes for more details.

Who to talk to about concerns if you’re in the hospital

If you need to go in the hospital, other health professionals will also be involved in your care. And your cancer doctor may not be the only one talking about treatment decisions with you.

Sometimes hospital policies and routines may upset your own schedule. In the hospital, you may be surrounded by noise and activity, which can be stressful. It is not uncommon to find it difficult to sleep there. It's also common to get annoyed or feel lonely and afraid. Some of this can’t be avoided, but you can bring up these problems with the nurses and other team members who are caring for you. They can offer ideas about ways that may help you cope. Some hospitals have patient navigators, social workers, and volunteers who can help you adjust to being in the hospital.

If you have a problem with a doctor or any other staff while you’re in the hospital, there are other people who may be able to help. Speak to your nurse, talk to a social worker, or ask for a patient representative or advocate. They can give you support and help you organize your thoughts. With your permission, they might even speak directly with your doctor.

Problems in the doctor-patient relationship

Sometimes people just have different communication styles that can cause conflict or concern. This can happen with your cancer doctor, too.  A doctor-patient relationship is a collaboration: if the collaboration isn’t working well, then you can feel frustrated.

If you have problems talking with your doctor, there are often ways to make things better. Try to work out your concerns before deciding the situation is hopeless.

First, tell your doctor as honestly and openly as you can what you’re worried about. Maybe you are worried that decisions are being made without your input. Maybe you are worried that you don't have enough information to make the decisions that you want to make. Maybe you are worried that you don't understand some things that are happening. All of these are understandable worries.

Here are some ways you may want to think about starting the conversation:

• “I’m worried that we aren’t communicating well, and here’s why ...”
• “I need to be able to talk with you about _________, and I feel like I can’t. Can we discuss this?”
• “I realize that you’re very busy, but I need to discuss _________ with you. Can we schedule a time to do that?”
• “I’m having trouble understanding ___________. Can you help me?”
• "I'm worried that we are not making decisions together and that I don't have much say in my care. Can we talk?"

If you are unable to work out the problem with your doctor during regular visits, ask for a special visit to discuss it.

If you feel things aren’t getting better, you might think about talking with a third party about the problem. Your family doctor might be willing to discuss the matter with the cancer doctor. Sometimes this is less stressful than facing the doctor directly, and their help could improve the situation.

Sometimes, just like in any other relationship, you may not have a good fit with your doctor. Don’t stay with a doctor to protect their feelings or because you were referred to a doctor and feel you shouldn't switch. An important part of a good patient-doctor relationship is good communication that shows respect and is open and honest. If you don't feel this level of trust, and want to find a new doctor, you have the right to do so. You must do what feels right to you.