Question 1

What records should I bring?

Accepted Answer

Bring whatever is available: referral letters, biopsy and histopathology reports, immunohistochemistry or molecular reports, imaging reports along with the scan images or CDs, operation notes, discharge summaries, recent blood tests, and a list of current medicines. If some documents are missing, the consultation can still proceed; the records can be reviewed later.

Question 2

Should the patient attend the first consultation in person?

Accepted Answer

Wherever possible, yes. A clinical examination and a direct conversation about symptoms, general fitness and preferences form an important part of planning systemic treatment. If travel is difficult, a family member may first bring the records for review, with the patient reviewed as soon as practical.

Question 3

Can a family member accompany the patient?

Accepted Answer

Yes. Many people find it helpful to have one or two family members present. Discussions may involve a considerable amount of information, and having someone else listening and taking notes is often useful.

Question 4

Is a biopsy always required before starting cancer treatment?

Accepted Answer

In most situations a tissue diagnosis is important before starting systemic cancer treatment, because the type and subtype of cancer determines the treatment. Occasionally the approach differs, for example when a biopsy is unsafe or when other confirmed tests are sufficient. This is decided individually.

Question 5

Will pathology slides or scans need to be reviewed?

Accepted Answer

Sometimes. Slides, blocks or scan images may be reviewed again, or additional stains and molecular tests may be requested on existing tissue. This is a routine part of confirming the diagnosis accurately and is not a criticism of the earlier report.

Question 6

Should I complete new tests before the appointment?

Accepted Answer

Usually not. Existing reports can first be reviewed, after which any additional tests can be selected appropriately. This avoids unnecessary duplication, cost and delay.

Question 7

Is it appropriate to seek a second opinion?

Accepted Answer

Yes. Seeking a second opinion is entirely reasonable and is a normal part of cancer care. Bringing complete records makes the second opinion more useful.

Question 8

Does every person with cancer require chemotherapy?

Accepted Answer

No. Some cancers are treated with surgery or radiation therapy alone, some with hormonal therapy, targeted therapy or immunotherapy, and some are monitored with careful observation. Whether chemotherapy is needed depends on the cancer type, stage, pathology and the person’s overall health.

Question 9

What is the difference between chemotherapy, immunotherapy, targeted therapy and hormonal therapy?

Accepted Answer

Chemotherapy acts on rapidly dividing cells. Targeted therapy acts on specific molecular changes within cancer cells. Immunotherapy works by helping the body’s own immune system recognise and act against cancer cells. Hormonal therapy is used for cancers whose growth is driven by hormones, such as certain breast and prostate cancers. These treatments may be used alone, in sequence or in combination, depending on the diagnosis.

Question 10

How is a cancer-treatment plan selected?

Accepted Answer

A plan is built from the confirmed diagnosis and subtype, the stage of disease, pathology and molecular findings, previous treatments, other medical conditions, general fitness, and the patient’s own goals and preferences. Published evidence and guidelines inform the options, which are then discussed with the patient and family.

Question 11

What do neoadjuvant, adjuvant, curative and palliative treatment mean?

Accepted Answer

Neoadjuvant treatment is given before surgery or radiation, often to reduce the size of the tumour. Adjuvant treatment is given after surgery or radiation to lower the risk of recurrence. Curative treatment aims to eliminate the cancer. Palliative treatment aims to control the disease, relieve symptoms and maintain quality of life when cure is not achievable; it may continue for a long period.

Question 12

What is a multidisciplinary tumour board?

Accepted Answer

It is a meeting where specialists — including medical oncology, surgical specialities, radiation oncology, pathology and radiology — review a case together and agree on the most appropriate sequence of treatment. This helps ensure that the plan is considered from several perspectives.

Question 13

Can cancer treatment be individualised using biomarkers or molecular tests?

Accepted Answer

In many cancers, yes. Tests performed on tumour tissue or blood can identify markers that indicate whether a particular targeted therapy, immunotherapy or hormonal treatment is likely to help. Not every cancer has an actionable marker, and testing is selected according to the situation.

Question 14

Can treatment be continued closer to the patient’s home?

Accepted Answer

In some situations, part of the treatment or the follow-up blood tests can be arranged nearer to home, with the overall plan supervised by the oncology team. Whether this is safe depends on the regimen, the monitoring required and the facilities available locally.

Question 15

What should I expect on treatment day?

Accepted Answer

Typically there is a review of symptoms, a check of blood counts and other relevant tests, and confirmation that treatment can proceed. Medicines to prevent nausea and other reactions are usually given first, followed by the treatment itself. The duration varies from a short injection to several hours.

Question 16

Can I eat before chemotherapy?

Accepted Answer

In most cases a light meal before treatment is appropriate and helps prevent weakness. Some specific treatments or procedures require fasting, so follow the instruction given for your particular regimen.

Question 17

Does chemotherapy always cause hair loss?

Accepted Answer

No. Hair loss depends on the drugs used. Some regimens cause complete hair loss, some cause mild thinning and many cause none at all. Where it occurs, hair usually regrows after treatment is completed.

Question 18

Can I work, exercise or travel during treatment?

Accepted Answer

Many people continue working and remain physically active, often with adjustments around treatment days. Gentle regular activity is generally encouraged. Travel plans, particularly long journeys, are best discussed in advance so that they can be timed around treatment and blood counts.

Question 19

Which medicines, vitamins or supplements should I disclose?

Accepted Answer

All of them, including prescription medicines, over-the-counter medicines, vitamins, herbal preparations, ayurvedic or homeopathic products and dietary supplements. Interactions with cancer treatment are possible, and some products can reduce effectiveness or increase side effects.

Question 20

Are there special dietary restrictions during treatment?

Accepted Answer

Most people can eat a normal, balanced diet. Food should be freshly prepared and well cooked, with attention to hygiene, particularly when blood counts are low. Specific restrictions may apply to certain treatments or medical conditions and will be explained where relevant.

Question 21

How frequently are blood tests required?

Accepted Answer

This depends on the regimen. Blood counts are commonly checked before each cycle, and sometimes between cycles, along with tests of kidney and liver function as required. The schedule is set by the treating team.

Question 22

Are vaccinations permitted during cancer treatment?

Accepted Answer

Some vaccines are recommended during cancer treatment, while live vaccines are usually avoided. Timing relative to treatment cycles matters. Discuss any planned vaccination with your oncology team beforehand.

Question 23

Can complementary or alternative medicines be taken with treatment?

Accepted Answer

Always discuss supplements, herbal products and alternative medicines with your oncology team before taking them, because interactions with cancer treatment are possible and some may affect the liver, kidneys or blood counts.

Question 24

When should I contact the oncology team?

Accepted Answer

Contact the team promptly if you develop fever, chills, bleeding, breathlessness, chest pain, persistent vomiting or diarrhoea, an inability to eat or drink, severe fatigue, confusion or any new symptom that is worsening quickly.

Question 25

What should I do if I develop fever?

Accepted Answer

Fever during or after chemotherapy should be treated as urgent, because blood counts may be low. Do not wait at home to see whether it settles and do not start antibiotics on your own. Contact your treating team immediately or attend the nearest emergency department for assessment and a blood count.

Question 26

How can nausea, diarrhoea, constipation or mouth ulcers be managed?

Accepted Answer

Preventive medicines are usually prescribed alongside treatment, and additional medicines can be added if symptoms persist. Small frequent meals, adequate fluids, good mouth care and gentle activity help. Report symptoms that are not controlled by the prescribed medicines rather than enduring them.

Question 27

What should I do if my food or fluid intake becomes poor?

Accepted Answer

Inform the treating team early. Poor intake can lead to dehydration, weakness and kidney problems, and it can often be corrected with adjustment of medicines, dietary advice or, when needed, intravenous fluids.

Question 28

When should I attend an emergency department?

Accepted Answer

Attend immediately for fever of 38°C or higher, difficulty breathing, chest pain, significant bleeding, uncontrolled vomiting or diarrhoea, inability to drink, markedly reduced urine output, new confusion or seizures, or rapidly worsening pain.

Question 29

How are leukaemia, lymphoma and myeloma different?

Accepted Answer

Leukaemias arise from blood-forming cells in the bone marrow and often affect the blood counts directly. Lymphomas arise from cells of the lymphatic system and commonly present with enlarged lymph nodes. Myeloma arises from plasma cells and can affect the bones, kidneys, calcium levels and haemoglobin. Each group is investigated and treated differently.

Question 30

Why is a bone-marrow examination performed?

Accepted Answer

The bone marrow is where blood cells are produced. Examining a marrow sample can confirm a diagnosis, show how much of the marrow is involved, and provide material for specialised tests that guide treatment and indicate prognosis.

Question 31

What are flow cytometry, cytogenetics and molecular tests?

Accepted Answer

Flow cytometry identifies the type of cells present by the markers on their surface. Cytogenetics examines chromosomes for abnormalities. Molecular tests look for specific gene changes. Together they refine the diagnosis and often determine which treatment is appropriate.

Question 32

Does an abnormal blood count always indicate cancer?

Accepted Answer

No. Infections, nutritional deficiencies, medicines, inflammation, thyroid disorders and many other conditions can alter blood counts. An abnormal result is interpreted alongside the clinical picture and, when necessary, further tests.

Question 33

Why might repeated blood tests be required?

Accepted Answer

A single reading is a snapshot. Repeating tests shows whether a value is stable, improving or worsening, which is often more informative than one isolated result and can avoid unnecessary invasive investigations.

Question 34

Is every low haemoglobin or platelet count an emergency?

Accepted Answer

No. The significance depends on how low the value is, how quickly it has changed and whether there are symptoms such as bleeding, breathlessness or chest pain. Individual results should be interpreted by your treating team rather than compared with reference ranges alone.

Preparing for cancer care

Preparing for Your First Consultation

Common questions, answered plainly

Before your consultation

Understanding cancer treatment

During chemotherapy or systemic treatment

Side effects and urgent concerns

Blood cancers

Seek urgent medical assessment