FAQs by patients

Q. How soon should I start screening for cancer?

The sensible way forward

For women:

• Clinical breast examination every year by a specialist (gynae or breast surgeon) starting at age 20.
• PAP Smear & HPV DNA starting a year after the first sexual intercourse every 5 years till age 65.
• Digital Mammography once between 40and 45 years and then every 2 years lifelong.

For men:

• PSA blood test once a year starting at age 55
• Low dose CT scan lungs every year for smokers more than 40yrs
• CEA and stool occult blood once in 3 years starting at 45 years
• Oral examination in Tobacco chewers / smokers once a year.

Q. Does a family history of cancer require an early start to screen for cancer?

Yes it does. It is recommended that cancer screening begins 10 – 15 years before the age at which the relative was diagnosed with cancer

Q. Does frequent mammograms increase the risk of breast cancer?

The risk of radiation exposure during mammography is extremely low. Therefore annual mammography is safe

Q. Is diagnostic imaging enough for a diagnosis of cancer?

No it is imperative to confirm the imaging findings with a biopsy. The cause of abnormal scans could be due to other conditions and not only cancer.

Q. How should one choose a treatment team?

It is important to remember that cancer are best treated by a good team of cancer specialists rather than an individual. This team should consist of Medical, Surgical and Radiation oncologists who work closely together. The track record, qualifications and experience of a cancer team also is important.

Q. Once a diagnosis is made how soon should their treatment begin?

As soon as possible. There is absolutely no reason to delay treatment. Delay allows the cancer cells to grow. By all means take one second opinion, but no 3rd, 4th and 5th opinions.

Q. When should one seek a second opinion?

Take a second opinion at the start of a treatment. Plan in order to re-enforce your confidence. Second opinions when things go wrong (and they can) usually don't help much. Make sure the team giving a second opinion is really nationally and internationally reknown.

Q. What should one do before starting chemotherapy?

Before chemotherapy

• Get a dental check up done.
• Do all necessary blood tests and a 2Decho before the procedure.
• Get a diet Plan from your doctor.
• Ask for a list of Do's and don't during chemotherapy and possible so you can prepare your mind and body
• Address all fertility issues with your doctor egg sperm banking & embryo cryopreservation especially if you are less than 25yrs.

Q. How soon after surgery should chemotherapy start?

Chemotherapy is given often after surgery to prevent a relapse of the cancer. It is assumed that microscopic cells remains behind after surgery and these grow later to cause the relapse. Treating patients with chemotherapy prevents this. In general chemotherapy is started 2 to 4 weeks after surgery.

Q. Why are there multiple modalities in the treatment of cancer?

Cancer cells can be attacked in 3 ways. Surgery to remove the main tumour, radiation to prevent it from coming back in the same place, chemotherapy to prevent it from spreading to distant organs. All 3 treatments given in sequence can therefore improve chances of a permanent cure.

Q. Is pain a big symptom of cancer treatment?

No. There is no permanent pain associated with cancer treatment. Temporary discomfort after cancer surgery or radiation is normal and easily treated. Chemotherapy is not painful.

Q. How do I deal with the fear of recurrence?

Fear of recurrence is one of the most commonest fears cancer patients face. It is a real fear. Recognize your fear and taking control of it helps to act as a motivator. Do not worry alone, join a support group to address this fear. Talking with the health care team about follow up will help address this fear. Seek mental health professional if the fear is overwhelming and if affecting the quality of your life.

Q. I feel isolated from my family, how do I connect with my wife / children?

Inspite of the information available for patients and their family, cancer is still surrounded by stigma. The most common emotions associated with cancer are fear, guilt and shame. Also the cost of the treatment often makes patients feel like a financially liability to the family. Often the only talk that takes place is about the disease, the treatment and the doctor's visit. Talking and sharing one's thoughts and feelings help in reaching out to the family, helping them to cope and adjust to the diagnosis together as a family.

Q. What is the main goal of cancer?

Cancer can occur anywhere in the body, the purpose of treatment is:

• Cure the patients and help them live a long and prosperous life.
• To prevent the cancer from relapse or spreading to other organs of the body.
• If the cancer is advanced the main goal is to reduce troublesome symptoms ( pain) of the cancer so as to improve quality of life and also prolong life.

Q. How do I know that chemotherapy works?

Chemotherapy is given in different situations, after surgery is given to prevent the disease from coming back so the direct effect is not seen, but, one knows it has worked when you remain well many years after treatment.

Sometimes chemotherapy is given upfront to shrink the tumour before surgery.

During treatment both clinical examination and tests with show that the tumour is shrinking and that chemo is working.

Q. How do I cope with fatigue?

Many patients complain of fatigue during and post treatment. What can you do to feel better

• Frequent and small meals help
• Adopting a high protein intake
• Moderate exercise and being active as much as possible
• Breaking the day with short naps
• Tracking haemoglobin levels
• Try different relaxation techniques

Q. Does chemotherapy shorten life?

No, chemotherapy does not shorten life.

Q. Can I take multivitamins during chemotherapy?

Yes, but in consultation with your treating doctor.

Q. Why is my sleep disturbed after I have started taking chemotherapy?

It is probably the steroid given alongside chemotherapy. However, please check with your doctor.

Q. Why can't I eat raw food during chemotherapy?

One can eat raw food as long its handled properly i.e. washed with potassium permanganate or veg wash. Certain fruits and vegetable which can be peeled can be eaten raw, eg carrots, beetroots, apple etc.

Avoid lettuce and raw leafy vegetables as they are difficult to clean thoroughly.

Q. Can chemo affect you years later?

Some chemotherapy drugs can have long term effects , on the heart, lungs and even infertility However, these side effects are very rare. Carefully planning of the dosing during treatment is done so as to avoid these rare side effects.