Ask Your Oncologist These 4 Questions Before Treatment

The right oncologist can unlock treatment options most patients never even hear about. #cancerdoctor #cancerpatient #chemotherapy

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Episode Description:

If you’ve been diagnosed with cancer, you’ve probably spent time thinking about:

 • Chemotherapy options
• Side effects
• Diet, supplements, and new treatments

 But almost no one asks this:

👉 Is my oncologist the right fit for me? Is our relationship working?

 And those questions can quietly shape everything about your cancer treatment.

In today’s breakdown, Dr. Jay walks through:

• Why your oncologist is the gatekeeper to advanced treatment options
• How genomic testing and biomarkers can completely change your plan
• What to ask if you want access to clinical trials or off-label therapies
• The biggest communication mistakes patients make (and how to fix them)

 This isn’t about blaming doctors—it’s about understanding how the system works so you can navigate it more effectively.

 If you want better access, better strategy, and better outcomes…

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Inquiries: 

info@elevatingcancertreatment.com

https://elevatingcancertreatment.com

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Disclaimer:
The information provided in this podcast is for educational and informational purposes only, and does not constitute medical advice. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard or read in this podcast or on this channel.
Reliance on any information provided by Dr. Jay Chaplin or Elevating Cancer Treatment is solely at your own risk. Dr. Jay Chaplin is a scientist and drug developer, not a medical doctor providing patient care. The content presented here reflects general scientific understanding and research, and may not be applicable to your individual health circumstances. Individual medical conditions and treatments vary, and no two situations are exactly alike.
Always consult with your personal healthcare provider before making any decisions about your health or treatment plan.

Transcript

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Doors open that most patients don't even know exist. There's a question I almost never get from clients. Now, people ask me all the time about the dose of their chemo. They ask about side effects. They spend hours on the internet researching supplements, diets, and things they half understood in a forum at 2 a.m. All legitimate concerns, by the way, and I'm happy to answer those. But almost nobody asks me the one question that controls access to nearly everything else in their treatment. Who is your oncologist? And are they actually the right person for you? And if not, how do you deal with a broken and unsupportive partnership? That's critical. Today we're giving you tools for getting the most out of your partnership with your oncologist. This is the most overlooked decision in cancer care. It's one of the things that I find consistently perplexing when I'm working with clients. How rarely the oncologist relationship comes up until it's completely broken. This is for anyone who has to work with an oncologist, either for yourself or for a loved one. This video will help you with picking the right one for you, knowing how to communicate effectively with them, and it also dives into some things you can do if the relationship isn't working. Hello, and welcome to Elevating Cancer Treatment, where we explain the science and debunk myths to help you navigate your health journey. My background is a little different. Beyond educating about cancer, I'm actually designing new drugs that are defining the future of oncology. This direct hands-on experience offers me a very different perspective of how these cancer treatments work on the body, interact with the cancer cells, and cause side effects. And these are insights that I'm excited to share with you. If that sounds interesting, make sure to like this video, subscribe to the channel, and hit that notification bell so you never miss an update. And please share it if you find it useful. I'm Dr. Jay Chaplin. An important reminder, I'm a PhD, not an MD. The information in this video is education and it's not medical advice. Every cancer is unique and no general information applies to everyone. Please remember that. Always consult with your healthcare provider for guidance on your specific situation. And two quick things. First, as a thank you for being here, I've created a free resource, 10 things to elevate your chemo journey, which you can download from the link below. And second, by signing up, you'll also get updates on that innovative cancer treatment I'm working on. I'm confident it represents a significant advancement in immunotherapy. So please take a moment, download your free guide, and join us in shaping the future of cancer treatment. Again, everyone's focused on the drug, the dose, the side effects, the diet, the supplements. All those are important. But your oncologist is the gateway to all the heavy-hitting things. And most people pick their cancer center the same way people pick a job. They pick the institution, not the person they're actually going to be working with every single day. Again, this is the same mistake people make when they join a company. They research the company, they read the Glassdoor reviews, they negotiate the offer, and they never once ask who their manager is going to be or how they interact with their staff. Then they find out, and suddenly the company doesn't matter nearly as much as they thought. I want to acknowledge, sometimes you don't seem to have a choice. You go to a cancer center, it's your local one, it's the best one around, and you get who you get. That's real. But if you have a choice, and you almost always have more choices than you realize, here's what I want you to hold on to. Your choice of oncologist is more important than your choice of cancer center. You can be at an extraordinary institution, and if your oncologist isn't aligned with you, that alignment problem will affect everything downstream. On the other hand, if your oncologist understands your position and supports you, and is willing to genuinely partner with you, doors open that most patients don't even know exist. For instance, and we'll talk about this later, an oncologist who is willing to write a letter to your insurance company stating that an off-label drug is a medical necessity for your specific situation, that can potentially get something covered by insurance that wouldn't normally be covered. That letter, that confidence from your oncologist can be the difference between access and no access for game-changing drugs. Conversely, an oncologist who plays it very safe, very by the book, and gives you only the most standard of care NCCN treatment for what may be a very uncommon case, you're probably leaving genuinely useful options on the table. It's a big difference. Remember, standard of care is written for the average patient. And if you're watching this channel, I'm going to go ahead and assume that you are not here to be average and to get average care. So, if you have the opportunity, interview multiple oncologists before you commit. Know their communication style, know how they think, know what they value, know what factors they use to make decisions. So here are the four questions that I think will tell you the most about who this person is and how you can partner with them. Question number one, NCCN versus off-label openness. Do you follow only the primary recommendations of the NCCN, or are you open to other treatments which are licensed for my specific condition? The NCCN, the National Comprehensive Cancer Network, sets the treatment guidelines most oncologists just default to. The first line recommendation is what the majority of patients receive. It's automatic. It's essentially the treatment playbook, well researched, broadly applicable, and like most playbooks, written for the median case, not necessarily for yours. The playbook should be adjusted for the particular conditions. Now, the answer you're hoping for when you ask a question like this is something like, I'm open to other options. That openness is really the only thing that you're screening for. You can't get specifics because you haven't gotten there yet. Question number two, genomic testing. Do you support genomic testing for my situation? Now, you may get pushback about insurance coverage, because these tests can often run $3,500 or more. I want to address that directly because it comes up constantly. And it is almost always the wrong pushback. First off, insurance usually covers genomic testing. It covers it in the vast majority of cases. And even in the uncommon situation where it doesn't, certain organizations, like Tempest, have a self-pay option. Did you even know that? Did your oncologist know that? Let me know down in the comments. So, you know what that out-of-pocket cost is for that $3,500 test? $295. It's a factor of $10, lower than $10. That's it. Less than most people spend on a month of custom supplements. For a comprehensive genomic profile of your cancer that allows optimization and personalization of your treatment plan to get you the best possible outcome. Often also opens up clinical trials. This is one of the most important pieces of information I can get from a patient. So if your oncologist says, I don't support genomic testing because you're not stage four yet, I want you to treat that as a red flag. The entire point of genomic testing is to guide treatment as early as possible so you don't progress to stage four. Waiting until you're advanced enough to qualify for that scenario is like waiting until the car is on fire before checking the engine. In many cases, genomic testing will show either susceptibility or resistance even to basic chemotherapy drugs. Now, this can guide treatment selection very early. I have had far too many clients who took years of chemotherapy, multiple rounds, multiple different lines, and had multiple failures, only to later have genomic testing show that their cancer was resistant to that chemotherapy all along, from the very beginning. That is a really hard thing to tell someone that all that time, all those side effects were wasted. So, if they're willing to sign off on sending your biopsy or resected tissue to Tempest, you can get this done for under $300. $300 is much better than wasting years on chemo or some other treatment that couldn't possibly work for your cancer. The really important question here is not about insurance, it's will they support testing or won't they? In this situation, it's not about the insurance. Again, $300 can cover it. It's about whether the oncologist will allow you to use your own tissue for this very valuable test. We have had several clients have this happen to them, and we've managed to find creative solutions for most cases. However, what you really want is for this to be an easy and supported process by your oncologist. The answer you're hoping for when you ask a question like this is something like, yes, as long as we have excess tissue, I support that. It makes it easy. So we go into detail about the importance of genomic testing in the video linked above. Question number three, clinical trial support. Are you willing to support me in finding clinical trials that are relevant for my scenario? This one matters more than most people realize. I've heard this from a number of clients. They have oncologists who are not willing to support them in entering clinical trials that they clearly are qualified for. Trials where they meet every single inclusion criterion and none of the exclusion criteria. They are perfect matches for the clinical trial, but the oncologist said no anyway. Because, in the oncologist's judgment, the patient wasn't advanced enough or something like that. What's happening here is the oncologist is making the decision about whether the patient can apply to the trial rather than letting you apply and letting the trial team do their job to make that determination. While they can interfere in this process, it's really not their call. It's the call of the clinical trials team. And that is a significant red flag. It hurts everyone, it hurts you, it hurts the clinical trials, it hurts the data that comes out. The answer you're hoping for when you ask this question is something like, yes, as long as it doesn't interfere with your treatment, I will support clinical trials. I can't guarantee that you'll be accepted, but let's try. So, bonus points. If they give you any input on ranking those clinical trials so that you have a clear first choice and you can apply to them in order. If not, please reach out to us and we can help you with that as well. Our contact info is down below in the description. Question four medical necessity letters for off-label use. If genomic testing identifies mutations where other drugs could be useful for my cancer, would you be willing to support a medical necessity letter for off-label treatment? So, a concrete example for one of our clients, you've probably heard this before. If a melanoma patient has an IDH1 mutation, there's a great drug for that. Would they write a letter stating medical necessity for a drug that was approved for that mutation in glioma, even though it's not approved for melanoma, a different cancer type? But the drug will work. Now, let's be honest, most oncologists are going to say no to this. But if you find one who says yes, that person is worth their weight in gold. You have found a unicorn, you hold on to that unicorn. The answer that you're hoping for when you ask this question is something along the lines of yes, as long as the data to support it are solid, we can try it. So before moving on, please drop a comment down below. What has your relationship with your oncologist been like? Collaborative, resistant, somewhere in the middle, your experience genuinely helps other people watching this. It is far too easy to feel alone. We are going to talk next about what to do if you're having a difficult time working with your oncologist. But before we get there, I want to talk about how to make proposals rather than asking questions. So let's say you already have an oncologist and you want to ask them for something. Here's one of the most common mistakes I see clients make. They come in with a vague question. What do you think about X, Y, and Z? Or have you heard about this thing I read online? Your oncologist has approximately 11 to 15 minutes with you. They are not available for philosophical discussions. They're already overloaded and overwhelmed. Don't come in with a vague question. Come in with a concrete proposal. Oncologists respond to clinical trial data. If not clinical trial data, they want to see very solid supporting data, good rationale, and they want to know that these things exist even if they don't go through the data themselves. The proposal has to be specific, implementable, supported, and clear. And here is a critical rule: one ask at a time. Even if you have five questions you want to ask, only ask one at a time and don't mention anything else until the question on the table has been resolved. It makes it much easier to process, it reduces the cognitive load for people who are already under stress. They are too, not just you. Always start with your most important question because you're probably going to run out of time before the last one is complete. For example, if you walk in with a list of several repurposed drugs and ask about interactions or recommendations, they'll be overloaded and tell you to just not take any of them. That's not because they don't care or that they're unhelpful, but because they genuinely cannot perform an exhaustive interaction analysis for all of these things and all of your existing treatments in the time that they have with you. But if you come in with one specific off-label drug at a specific dose and ask, are there reasons that I shouldn't take this? you can get a clear, useful answer. Now, there's also a more strategic layer to this. Please know how your oncologist thinks. Are they primarily concerned with insurance coverage? Figure it out ahead of time. Check with your insurance company what's covered and at what level before you come in. Frame your proposal around that. Have that fact dialed in. Are they worried about side effects? Which would be fair because adverse events on their patients reflect badly on them. Find out what the actual tolerability data are and lead with it. We talked about that in a previous episode. Do they genuinely question whether the thing you're going to propose is effective? Then they need to be educated about efficacy. That's a completely different conversation entirely. Insurance doesn't matter to that. You need clinical trial data. You need to show efficacy. If you know how they think and what they make their decisions based on, you can tailor your supporting material around what they will find most compelling. Same proposal, completely different framing. Again, if you don't know how to do this, it's one of the ways we support our clients so that they can be prepared for these discussions. So here's what I want to leave you with. Everyone asks about doses, drugs, diets, and things they read online. Completely valid. Almost nobody asks, do I have the right oncologist and am I working with them in the right way? Those two questions will shape your entire treatment experience. More than almost anything else you can do. They are the gatekeeper to your high-leverage options on this treatment journey. They can be your biggest obstacle or your biggest support. Please manage those carefully. Manage your relationship with your oncologist carefully. If you want help working through your specific situation, figuring out what to ask for, how to frame it, or whether your current treatment plan has gaps in it, again, that's what we do. The link is in the description. And this is way easier if your oncologist is on board. So please leave a comment. Tell me what your experience with your oncologist has been like. Has it been collaborative? Has it been frustrating? Did something shift when you pushed back? Positive or negative? I read these as do other subscribers, and your story might be exactly what somebody else needs to hear today. So if this video was useful to you, please like, subscribe, and share it with someone else who's navigating this. And don't forget to hit the notification bell so you never miss an update. So, what do you do when the relationship is already completely off the rails? If the relationship is degraded, you've already polarized, you feel blocked, and you don't know how to move forward.