INitial VIsit

The beginning of a cancer journey is often very overwhelming. This is the time when you will have the most questions. A this time, some of the information may be difficult to process and you must decide how much information you want upfront. Remember, your healthcare team is available to answer all of your concerns and you need to be mentally prepared to understand this important information. You may want to bring a friend to your first appointment to help you understand and remember all the new information. 

1. Can you determine the stage of my cancer at this time? What further tests are needed for staging?

Rationale: Oftentimes staging cannot be determined from a CT scan alone, further testing may be needed for the most accurate diagnosis which will guide treatment decisions. 

2. Has the cancer spread (or "metastasized")? Where has it spread to? How does it change the treatment plan?

Rationale: Cancer can spread locally or distantly. Local spread infiltrates tissues near the stomach (e.g. the lymph nodes),  while distant metastasis means that the cancer has spread to distant organs (e.g. the liver). The degree of spread can affect treatment options.

3. How much experience do you have in treating stomach cancer?

Rationale: This is an important question to ask your healthcare team and particularly your surgeon. An experienced healthcare team will improve the quality of your care. It is important to be your own advocate and request care from a qualified team. Please note that in more remote areas, your team may have limited experience in treating stomach cancer. It is up to you as the patient to decide how to proceed. For example, a technically skilled surgeon can improve your survival but to get access to this surgeon you may have to travel or wait on a wait list .

4. Do I qualify for surgery? Is the goal of surgery curative or palliative?

Rationale: Patients with early stage stomach cancer may be eligible for stomach removal surgery, called a gastrectomy. Later stage patients may need to get "neo-adjuvent chemotherapy," which is chemotherapy given before surgery to try to shrink the tumor size. Palliative surgery may be needed to remove a tumor that is causing symptoms. The intent of palliative surgery is to treat the symptom, but not to provide a cure.

5. Will I need to stay in the hospital after my treatment? How should I prepare for hospitalization? How long do I need to stay? How can I arrange home care?

Rationale: Certain treatments may require hospitalization. Some hospitalization may be planned (e.g. after surgery), whereas other hospitalization may be unplanned (e.g. complications). Home care may be arranged in certain instances.