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Questions to Ask Your Doctor

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You should play an active role in selecting your cancer care team and learning more about your treatment plan so you can lessen any long-term complications associated with the surgical procedure.

Researchers have evaluated which factors associated with a clinician and/or hospital can lead to the best outcomes for people with head and neck cancer. Notably, people with head and neck cancer who were treated by surgeons who performed a high volume of surgeries had the best outcomes.1, Ko CY, Chang JT, Chaudhry S, Kominski G. Are high-volume surgeons and hospitals the most important predictors of in-hospital outcome for colon cancer resection? Surgery. 2002 Aug;132(2):268-73. 2, Karanicolas PJ, Dubois L, Colquhoun PH, Swallow CJ, Walter SD, Guyatt GH. The more the better?: the impact of surgeon and hospital volume on in-hospital mortality following colorectal resection. Ann Surg. 2009 Jun;249(6):954-9.3Billingsley KG, Morris AM, Dominitz JA, et al. Surgeon and hospital characteristics as predictors of major adverse outcomes following colon cancer surgery: understanding the volume-outcome relationship. Arch Surg. 2007 Jan;142(1):23-31; discussion 32.  Similarly, if people with head and neck cancer were treated at hospitals where a high volume of surgeries were performed, these patients had improved survival versus those receiving treatment at a center where a low volume of surgeries were performed.4Hillner BE, Smith TJ, Desch CE. Hospital and physician volume or specialization and outcomes in cancer treatment: importance in quality of cancer care. J Clin Oncol. 2000 Jun;18(11):2327-40. Therefore, you may want to consider asking your potential cancer care team whether they perform a high volume of surgeries for people with head and neck cancer.

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There are other steps you can take to optimize your treatment outcome as well, such as consulting with a registered dietician and swallowing therapist before you begin treatment and throughout your treatment course. These specialists can assess whether your nutritional needs are being met and whether you have swallowing difficulties and offer therapies that can improve your quality of life.

Here are some questions you might consider asking your potential cancer care team prior to beginning treatment.

Questions to ask your cancer care team

You may want to ask your potential cancer care team the following questions before receiving surgical treatment for your head and neck cancer:

  • What is the main treatment goal associated with your planned surgery (i.e., curative, palliative)?
  • Is surgery the best treatment option for you? Are there other treatments options that may be considered?
  • Are you likely to be administered other treatments after the completion of surgery? If your surgeons do not yet know the likelihood of follow-up treatment, what factors will the cancer care team evaluate during or post-surgery to determine whether another treatment type may be needed?
  • What is the likelihood of swallowing and speaking difficulties during and after surgery? Are there exercises you should perform to maintain or improve these functions both pre- and post-treatment?
  • What are potential side effects that may be associated with your particular treatment course? Are there steps you can take to lessen these potential side effects, and/or should you report certain side effects to other cancer care team members?
  • What are the likely long-term complications associated with your course of treatment?
  • Are you likely to have problems with eating post-treatment? Are there dietary recommendations you should follow pre- or post-surgery to obtain adequate nutrition?
  • Do your surgeons have experience performing surgeries for head and neck cancer? Is the hospital where you will be treated a high-volume treatment center for head and neck cancer? If not, are there other surgeons and/or health care facilities that they would recommend?
  • Are you likely to need reconstructive surgery?
  • Is it likely that your surgeon will also remove lymph nodes? If so, from what regions of the neck and/or how many lymph nodes does the surgeon plan to remove?
  • How long will recovery take? Does your health care team recommend that you take time off from work for an extended amount of time for both surgery and rehabilitation?
  • Would a clinical trial provide you with access to other treatment options? Do you qualify for any of these clinical trials?
  • In addition to consulting with a surgeon, speech/swallowing therapist and registered dietician, is there anyone else you should consult prior to receiving surgery for your head and neck cancer?

References

1 Ko CY, Chang JT, Chaudhry S, Kominski G. Are high-volume surgeons and hospitals the most important predictors of in-hospital outcome for colon cancer resection? Surgery. 2002 Aug;132(2):268-73.

2 Karanicolas PJ, Dubois L, Colquhoun PH, Swallow CJ, Walter SD, Guyatt GH. The more the better?: the impact of surgeon and hospital volume on in-hospital mortality following colorectal resection. Ann Surg. 2009 Jun;249(6):954-9.

3 Billingsley KG, Morris AM, Dominitz JA, et al. Surgeon and hospital characteristics as predictors of major adverse outcomes following colon cancer surgery: understanding the volume-outcome relationship. Arch Surg. 2007 Jan;142(1):23-31; discussion 32.

4 Hillner BE, Smith TJ, Desch CE. Hospital and physician volume or specialization and outcomes in cancer treatment: importance in quality of cancer care. J Clin Oncol. 2000 Jun;18(11):2327-40.