The First Steps

When the Doctor Says Cancer

It is a situation that is universally feared: sitting in the doctor's office and hearing that you have cancer. People diagnosed with cancer often say they were stunned upon hearing the diagnosis, unable to hear much of what was said afterward. After the initial shock, most people begin to look for sources of support.

Seeking support

It is important to understand your disease and the process of diagnosing and treating it. During the initial visit, absorbing the news of cancer and its unfamiliar medical language may be difficult to comprehend. You may want to take a family member or a friend who will not only be supportive to you, but can also act as your ears and memory. A tape recorder can also achieve the same goals of obtaining information.

However you choose to accurately record information, it is important to do so. Getting the facts right about your situation will help you make appropriate decisions in the coming days. Additionally, being an informed, involved patient and voicing your questions and concerns can be helpful to you and your doctor and nurse in forming a partnership in your care. It is understood that some patients want to know more information and others less. Make your doctor and nurse aware of how you prefer to be given information about your diagnosis, treatment, and prognosis. Don't be afraid to ask questions or to let your doctor know that you don't know what questions to ask. The following questions may be appropriate to ask your oncology team:

  • What is the exact type and name of the cancer I have?
     
  • How was it diagnosed?
     
  • What tests were taken and what did they show?
     
  • Will I need additional tests to further diagnose my disease?
     
  • What stage is the cancer and what does that mean?
     
  • What are my treatment options and what side effects can I expect?
     
  • What is my prognosis? What will my quality of life be?
     
  • What are the next steps?

Absorbing news of cancer and communicating with your doctor are part of the coping process. Many resources are available to understand the nature of coping. Your oncologist can provide resources, including names of psychologists, group therapists, and written materials. Don't be afraid to ask for them. Understanding your emotions—and those of people close to you—can be helpful in managing your diagnosis, treatment, and process of healing.

Illness changes our relationship to the world. Being diagnosed with cancer is a difficult experience, and it is inevitable that there will be days when you cannot make yourself feel hopeful. That is normal, especially if you feel physically sick or tired. Take care of yourself during those difficult times and realize that much has been learned and applied in recent years to help ease the process of cancer treatment as much as possible. Talk to your health-care team about what can be helpful.

Get organized

As you visit your oncologist or surgeon or speak with your radiation oncologist, you will gather a large amount of paperwork, test results, and personal notes. Create a system for all these papers that will streamline correspondence with your insurance company and help you communicate more accurately with your specialists.

A good system will allow you to make the most of your time with your health-care providers by having your questions readily available and information close at hand. For more information on how to get organized, see Cancer.Net's section on Managing Your Care.

Consider a second opinion

A second opinion is standard practice in medical care. In fact, many doctors encourage their patients to seek second opinions.

As you begin to evaluate doctors for a second opinion, you can ask others who have been treated for your particular cancer, you can ask your doctor to make a referral, or you can call local or regional comprehensive cancer centers. (Look for a clinician with a practice focused exclusively on that particular type of cancer.)

  • Residents of California: The Second Opinion is a non-profit organization that provides multidisciplinary second opinions to newly diagnosed or recurring cancer patients.  For more information on this service, please reference the following website: thesecondopinion.org

Get support

Research has shown that voicing fears and anxieties with family or friends, counselors, clergy, or support groups can serve to strengthen the patient emotionally, and perhaps even physically. However, not all people find it easy to open up to other people. Therefore, feelings can be expressed by:

  • Writing in a journal
  • Artistic projects, such as painting
  • Praying
  • Reading
  • Slowing down and reflecting

However, even with outlets to express emotions, sometimes patients may experience anxiety and depression. If you find yourself uninterested in normal activities for more than a few weeks, you should tell your doctor.

Additional resources

CancerCare

American Cancer Society

National Cancer Institute

*adapted from "When the Doctor Says Cancer" from cancer.net

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cholangiocarcinoma, or bile-duct (bile duct) cancer, arises from the tissues in the bile duct.