Questions for Evaluating Cancer Treatments and Providers

These questions do not apply to all cancer treatments and cancer providers. Some of them are more appropriate for conventional cancer treatments and cancer providers while others are more specific to integrative and/or alternative providers. Take the time upfront to think through these categories and ask questions toward a fully informed decision. Remember that any claims about curing cancer must be well-substantiated.

1. Treatments, Efficacy and Safety
   1. What are the conventional cancer treatment options for your type and stage of cancer? What is being recommended for you? What cancer clinical trials are available?
   2. What are the integrative cancer treatment options? What is being recommended for you?
   3. What treatments would the provider choose for his or her self, or a loved one?
   4. What evidence exists regarding the potential efficacy of recommended treatments?
   5. What are the predicted outcomes with and without treatments?
   6. In the provider's experience with your diagnosis, what is the average time to response and specific types and length of disease response, including stable disease, partial response, and complete response? How does the practitioner define each of those terms?
   7. How long will the treatments last? How often are treatments required? Will the provider create a treatment plan for the entire length of therapy?
   8. Will treatments occur in a hospital, clinic, or self-administered at home?
   9. What team members will be involved in your care? What are their roles?
   10. How are patient progress and response rates monitored over time? What tests are recommended, and how often?
   11. What is the safety profile?
   12. What risks are associated with treatments?
   13. How does the provider define the ratio between potential risks and benefits of treatments?
   14. What is the impact from treatments on quality of life? How do the treatments impact day-to-day activities?
   15. What short and long term side effects are associated with the cancer treatments?
   16. How are side effects such as pain controlled and managed?
   17. Do the treatments cause changes in sexual function and/or fertility?
   18. What can be done to support your body during and after treatments?
   19. Is it possible to get a secondary cancer from the treatments?
   20. Is it possible that your type of cancer will spread due to the treatments?
       
       
2. Quality of Evidence Related to Cancer Studies
   1. What scientific articles have been published about the treatments being recommended?
   2. What is the scientific basis and history of the treatments?
   3. Has the provider published scientific articles related to the treatments?
   4. What is the experimental nature of the treatments, if any?
   5. If the provider is using experimental therapies and conducting research, have they published their results, and if not, why?
   6. Do studies exist about the cancer treatments independent of the provider and health care facility?
   7. Who has funded studies evaluating the treatments?
   8. Have any studies been published in quality journals?
      
      
3. Qualifications and Experience
   1. How many people has the provider treated with your diagnosis? How many people have they treated overall throughout their career?
   2. What is the provider's degree and from what institution? What are their credentials such as board certification of a specialty and subspeciality?
   3. How long have they been in their current practice? What is their professional history prior to their current position?
   4. Do they have a teaching appointment at a medical school, and if so, where and instructing on what topic?
   5. Do they conduct research, and if so, what types of research?
   6. What professional societies do they belong to?
   7. Who do they collaborate with in their field? Who is a part of their professional network? Is their network based in the country where they are practicing or elsewhere? Are the members of their network working more inside of outside of the provider's discipline?
   8. What compelled the provider to gain expertise in their discipline?
   9. What discoveries throughout the provider's career have informed their current regimen?
      
      
4. Integrity, Consistency and Reliability
   1. What is the provider's bedside manner?
   2. How do they communicate?
   3. How do they sound?
   4. What are their ethics and values?
   5. Do they seem rational?
   6. Do they seem honest?
   7. Is what they say and do consistent?
   8. Do they present as a solid and whole person in their role as a health care provider?
   9. Is their clinical model fixed or evolving?
   10. If their model is evolving, are the changes sensible or whimsical, erratic behavior? Do any whimsical, erratic changes reflect the provider's confusion and desire to experiment on patients?
   11. Do they walk their talk?
   12. Are they available to patients outside of appointment times for emergencies?
       
       
5. Integrative Care
   1. What is the provider's knowledge base about integrative cancer care?
   2. What integrative cancer care plan are they recommending for you, if any?
   3. If the provider is not integrative, do they have experience in working with patients who are using integrative approaches?
   4. Does the provider ask you about any and all of the integrative cancer therapies you are using? Are they fostering a patient-centered conversation on the topic?
   5. Does the provider have knowledge about and plan therapies so that they integrate with and optimize any conventional treatments?
   6. If the provider is prescribing herbs, do they have a knowledge base and continue studying emerging scientific evidence about herb/drug interactions and incorporate that knowledge into patient recommendations?
      
      
6. Customized Care
   1. Does the provider have a one-size fits all approach?
   2. Do they see each patient as an individual?
   3. Are they making any recommendations based on general knowledge versus insights about you as an individual?
   4. Is the attitude my way, or the highway in their practice?
   5. If relevant, are they making any recommendations based on their own health experiences?
      
      
7. Success
   1. What are the provider's measurements of success?
   2. What is the provider's definition of treatment success?
   3. How does the provider's definition of treatment success compare to your definition of treatment success?
   4. What are characteristics of patients that respond to therapies? 
      
      
8. Power
   1. Is the provider trying to empower you, or do they want you to rely on them for power?
   2. Are they guiding you to find power and wisdom within?
   3. Do they respect you as a participant in your own choices?
      
      
9. Passion vs. Substance
   1. What is the methodology and foundation of the practitioner's work? Some providers are more outwardly passionate about their work and this can cloud a patient's ability to discern the value of the treatments and therapeutic relationship.
      
      
10. Boundaries
    1. What are the provider's boundaries in relation to you?
    2. Is the provider leaving their private life outside of the treatment room?
       Sometimes it is appropriate for providers to share personal vignettes, but often it is not.
       
       
11. Money
    1. What is the estimated cost for the treatments?
    2. Does this include follow-up care?
    3. Does your health insurance plan provide coverage for the services and treatments?
    4. Are the provider's fees appropriate to their qualifications and services?
       
       
12. Trust Yourself
    1. Trust your intuition and instinct about the provider and their treatments. Find the provider and treatments that feel right to you. Act on any concerns that you have. Moving on and continuing searching is better than staying in a situation that is not working and conducive to your optimal health and healing.
       
       

Additional Questions for Evaluating Overseas Clinic

1. Clinic Staff
   1. How many staff members does the clinic employ?
   2. How many of them are medical doctors?
   3. How many of them are credentialed medical doctors in the clinic's country?
   4. How many of them are oncologists?
   5. Does the clinic staff speak conversational English with a medical vocabulary?
      
      
2. Treatment Administration
   1. What doctors will administer treatments?
   2. What are the qualifications of other clinic staff members that will administer treatments?
      
      
3. Support
   1. Are any clinic physicians available outside of office hours for emergencies?
   2. Does the clinic recommend that the patient have a companion with them for supportive care?
   3. Does the clinic have any staff members to provide psychological support to patients? If so, how many staff members and what are their credentials? Is there an extra fee associated with this support?
      
      
4. Geography
   1. Does the clinic recommend a temporary move to their part of the world, and/or several visits to the clinic over an extended period of time?
   2. How does being away from home affect patients and their loved ones?
   3. Outside of the clinic in the town and surrounding areas, to what extent do people speak English?
      
      
5. Housing
   1. Does the clinic provide housing? If not, do they offer assistance with locating housing?
   2. Is it possible to find housing within a reasonable commute of the clinic?
   3. What forms of transportation are available between potential housing locations and the clinic?
      
      
6. Food
   1. Does the clinic provide food to patients and their loved ones? Is it healthy?
   2. Are there nearby dining venues with healthy food?
   3. Does the clinic maintain a list of their top recommendations?

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