Five Questions to Have Answered After a Diagnosis

What should newly diagnosed colon cancer patients ask their doctor?

newly diagnosed colon cancer patientsNewly diagnosed colon cancer patients will have many, many questions they will want answers to. It is a very dizzying time. So many ask, where should I start?

Dr. Madappa Kundranda lists the top five questions he thinks patients should have answered early in the diagnosis process. There are many different types of cancer, it is most certainly not a one-size-fits-all disease. Everyone’s experience and case will be different. Knowing more about your cancer can give you a better idea of what your treatment will look like and will empower you, as a patient, to get the best care from your doctor.

Video Transcripts

Madappa Kundranda, MD: It is extremely important for a patient who is newly diagnosed with colon cancer to have several of these questions answered. I breakdown these questions into five big components:

Number one, determine what stage of colon cancer it is and whether it is curable. Why is this important? The different stages of colon cancer ranging from one to four and not all of them are curable and hence knowing that is an important part of it.

Number two, knowing what chemotherapies are used and the side effects of these chemotherapies are important. Again, why is this important? That is because if you are going for a curative intent, dealing with toxicities becomes more palatable for the patient saying it is a short-term goal. If you are dealing with stage 4 colon cancer, wherein you are dealing with the risks and benefits and the longevity of life to the quality of life, the toxicities tend to be more important in the context of this because the quality of life is equally important.

Number three, ask your doctor if there are any appropriate clinical trials and why is this question important? Previously, there was this pre-misconception that clinical trials meant that we have exhausted all options and this is absolutely incorrect, the reason being, clinical trials and appropriately chosen ones are very effective and that is how we have had these standard of cares established that we are using in our day to day practice to treat colon cancers and other cancers. Hence, having an appropriate clinical trial to see if you are eligible for that is extremely important. You can always use standard options at a later point and hence, this is a question that needs to be addressed.

Number four, ask your doctor if there is a nutritionist that is an integral part of your cancer treatment team. Why is this important? We have seen it very often that patients do well from a cancer therapy standpoint, their disease is under control when you look at it on scans, when you look at it, when you look at the tumor markers, however, the nutritional support is inadequate and hence, they continue to lose weight. When you lose weight, the tolerance to chemotherapy decreases and then you go down the spiral, hence, it is very important for a patient to actually have a nutritionist to be a part of his or her team. In my clinical practice, I have my nutritionist that meets with the patient and their caregiver, every time the patient sees me in an effort to improve and maintain their nutritional status for the same purpose.

The last component of all of this is in the context of a multidisciplinary approach. What is the multidisciplinary approach? This is where you have a medical oncologist, a radiation oncologist, a surgical oncologist, a geneticist, an interventional radiologist, a gastroenterologist and this whole team of healthcare providers working under one roof for the sole purpose of helping you fight this cancer with any and all modalities. The reason why this is so important is because in our practice of medicine today, unfortunately, the care has been fragmented and hence, people, the right hand does not know what the left hand is doing. Hence, working with the multidisciplinary approach with all of these healthcare providers under one roof and having that care is very important to getting the best quality of care.

Madappa Kundranda
Dr. Madappa Kundranda obtained his medical degree from Bangalore University in India, before earning a PhD in cancer biology from Meharry Medical College in Nashville. Dr. Kundranda next completed an internship and residency in internal medicine at Fairview Hospital, a Cleveland Clinic Hospital. He then finished a hematology/oncology fellowship at the Mayo Clinic in Scottsdale, AZ. He is currently a medical oncologist with Western Regional Medical Center.


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