Talking to oncologists | ASK THE EXPERT

Dr Ben Forster is a medical oncologist and palliative care physician. He recently presented at BCNA’s information forum in Cairns and answered many questions at our metastatic breast cancer breakfast. We thought we would share some of those with you.

How do I talk to my doctor about the side effects of my treatment?
Having an open and honest relationship with your oncologist is key to providing you with the best possible quality of life. Whether you are dealing with pain, fatigue, mouth ulcers or sleeplessness, it is really important to talk to your medical team.

Try to be specific about how you are feeling, write down the side effect, the times you notice it and how it is affecting you. That will help your doctor to understand what is going on and give you the best possible solutions.

Should I be exploring complementary or alternative therapies?
It is important to understand the difference between complementary therapies and alternative therapies.

Complementary therapies are used alongside your medical treatment. They are often used to help manage side effects. Alternative therapies are used instead of conventional treatment.

The first piece of advice I would give you is that if it sounds too simple, it probably is too simple.

Complementary therapies such as meditation, yoga and acupuncture may be helpful for some people. If you are going to explore complementary therapies, see a registered practitioner.

It is important to note that some complementary medicines, including some vitamins and herbs, can interfere with chemotherapy and may make it less effective. Please talk to your oncologist about any complementary medicines you are taking or thinking about taking.

You may find some useful information on the Memorial Sloane Kettering Cancer Centre’s About Herbs website, mskcc.org.

I really want to travel overseas. Can I?
We want to help you live your life well. Talk to your oncologist about your wish to travel and how this can fit in with your treatment.

Australia has reciprocal health care rights in some countries, including Belgium, Finland, Italy, Malta, the Netherlands, New Zealand, Norway, the Republic of Ireland, Slovenia, Sweden and the United Kingdom. Consider taking your holidays in one of these countries, as it is unlikely you will be able to get travel insurance to cover any breast cancer related illness. BCNA has an excellent travel insurance fact sheet that includes practical advice.

It is important to plan well, but not too far in advance. Work with your medical team to be as prepared as you can be. Take a copy of your latest blood tests and scans with you. Take your medications in your hand luggage, along with a letter from your oncologist explaining why you are carrying them. Take antibiotics in case you need them.

When you are on your flight, ask for an aisle seat, avoid caffeine and alcohol, and keep moving. This will reduce the risk of blood clots.

How do I talk to my oncologist about my prognosis?
No oncologist has a crystal ball. Answering this question is never easy. What we can tell you is what the research has found. What is the ‘average’, what is the worst case scenario, what is the best case scenario. There are so many variables – where in your body your disease is, how it is responding to treatment, what other treatment options you have. The best advice is to keep talking openly with your team.

When I’ve had enough treatment, how do I talk to my medical team and family about it?
It can be hard for both the patient and the doctor to talk about stopping treatment and focusing on end‐of‐life care. You may need to start the discussion.

Your doctor should give you clear answers to any questions you ask. This is your experience, your body and your life, so you have the right to control it.

Have a discussion with your oncologist about how advanced your cancer is, what treatment options you still have, the benefits and side effects, and then weigh it up yourself.

I highly recommend seeing a social worker or counsellor to help you sort through your thoughts. They will be able to help you with the discussions with your medical team and your family.

This will be a highly emotional time for you and your family. It can be helpful to take your family through the pros and cons of continuing treatment, so that they understand your thoughts and feelings.

If you do decide to stop treatment, work closely with your team to ensure you have the best possible quality of life, so you can enjoy those special life moments.

Issue 79
Winter 2017