Questions to Ask — Before Chemotherapy Starts
Most people walk into their first chemotherapy consultation with fears shaped by someone else's story. Walking in with the right six questions changes that conversation — and gives you something concrete to hold on to.
Medically reviewed by Dr. Bharati Devi Gorantla, Medical Oncologist, MBBS · MD · DM (Adyar, Chennai) · ECMO · MRCP SCE (UK) · Last reviewed September 2026
- Intent is the first question — What the treatment is trying to achieve shapes everything else — the number of cycles, how side effects are weighed, and what counts as the treatment working.
- Side effects are specific to you — Your oncologist can tell you which effects are most likely for your treatment plan — not a general list of everything ever reported.
- Cost is a fair question — The total expected cost of a course of chemotherapy, including supportive medicines and blood tests, is a reasonable thing to ask before you begin.
- Write the answers down — These consultations are hard to remember clearly afterwards. Bring a notebook, or ask whether you can record the conversation.
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Before chemotherapy begins, ask your oncologist six things: what is this treatment trying to achieve, how many cycles are planned, what side effects are most likely for you specifically, how will daily life change, what is the total expected cost, and who do you call if something goes wrong between appointments. Write the answers down.
Words your oncologist will use — and what they mean
- Intent
- What the treatment is aiming to do. Curative intent aims to eliminate the cancer. Adjuvant intent means treatment is given after surgery to lower the chance of the cancer returning. Palliative intent means the treatment is aimed at controlling the cancer and managing its effects over time. The intent shapes the whole plan.
- Protocol or regimen
- The specific combination and schedule of treatment chosen for your cancer. Your oncologist selects it based on your cancer type, stage, and general health. You do not need to memorise it, but you can ask for a written summary to take home.
- Cycle
- One complete round of treatment, including the rest period that follows. Cycles are usually two to four weeks long, and most courses involve several of them. Knowing the cycle length helps you plan work, travel, and family commitments in advance.
- Nadir
- The point in each cycle when your blood cell counts are at their lowest, which is when you are most vulnerable to infection. Your team will tell you when your nadir falls and what to watch for. Fever during this window is treated as an emergency — not a wait-and-see situation.
- Response assessment
- The scans or blood tests done during or after treatment to check whether the cancer is responding. Ask when the first assessment is planned and what it will look at. PET-CT or CT scans are coordinated through partner imaging centres.
- Daycare
- Treatment given as an outpatient — you arrive, receive your chemotherapy, and go home the same day. Most chemotherapy at CION centres is given as daycare. An overnight stay may be needed for some treatment plans or if a reaction occurs during the session.
What does the treatment intent mean for your plan?
| Curative | Adjuvant | Palliative | |
|---|---|---|---|
| What it means | Aims to eliminate the cancer | Aims to lower the chance of return after surgery | Aims to control the cancer and manage its effects |
| Typical setting | Early or locally advanced cancer | After surgery, no visible remaining disease | Advanced or metastatic cancer |
| Number of cycles | Fixed number, then reassessment | Fixed number, set in advance | Ongoing, reviewed at each assessment |
| What success looks like | No evidence of cancer on reassessment | Remaining cancer-free after surgery | Stable disease, managed symptoms, quality of life maintained |
| How side effects are weighed | Higher short-term burden accepted for the long-term aim | Balanced against the risk of cancer returning | Comfort and daily function are central to every decision |
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Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
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Did you know?
ASCO guidance on shared decision-making notes that patients who write their questions down before the appointment are more likely to leave understanding their treatment plan.
Most oncology consultations have time set aside for questions. The barrier is usually not time — it is not knowing which question to start with.
Source: ASCO Shared Decision-Making Guidance
The six questions — and what to listen for in the answer
What is this treatment trying to achieve?
This is the most important question on the list. The answer tells you whether the goal is to eliminate the cancer, reduce the chance of it returning after surgery, or manage it over time. Each intent leads to a different kind of plan and a different way of thinking about side effects. If the answer is unclear, say so directly: are we aiming to eliminate this, or to control it? Both are valid answers, and you deserve a clear one.
How many cycles are planned, and how will we know if it is working?
Ask for the planned number of cycles and when the first response assessment will happen. Ask what the assessment will look at and what the possible outcomes are. Knowing the plan in full helps you pace yourself — physically, emotionally, and practically. It also means you are not hearing about a scan for the first time the day before it happens.
What side effects are most likely for me, specifically?
Ask your oncologist to name the effects most likely with your treatment plan — not everything ever reported, but the ones your team expects to manage for someone with your treatment and your health. Ask what you should watch for that needs a same-day call, and what is normal enough to manage at home with guidance. Write the answer down on the same day you hear it.
How will this change my daily life — work, diet, and travel?
Ask directly: can I work during treatment, and if so, for how long each week? Are there foods or supplements to avoid? Is travel safe between cycles? If you take any Ayurvedic, herbal, or other traditional preparations, tell your team now, before treatment begins. Do not stop or start anything without telling your oncologist — this is one of the most important things you can do to keep yourself safe during chemotherapy.
What will this cost in total, and what does my insurance cover?
Ask for the total estimated cost of a full course, including medicines given alongside chemotherapy, blood tests between cycles, and response-assessment scans. Ask what your insurance covers and whether anything needs pre-authorisation. The answer may be an estimate rather than a fixed figure, but an honest estimate helps you plan. Ask who to speak to about the financial side if the consultation itself is not the right time to go through the detail.
Who do I call if something goes wrong, and when?
Before you leave the appointment, get a specific contact — not a general helpline, but the number your team wants you to use between cycles. Ask what signs mean a call right now, and what can safely wait. Fever during your nadir window is one answer that should always come up. Write the contact details on the same page as everything else, and make sure someone else in your household has them too.
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Still not sure what applies to you?
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Frequently asked questions
Is it normal to feel too frightened to ask questions in the appointment?
Yes. Most people leave their first consultation having understood less than they expected — not because they were not paying attention, but because the situation makes information hard to absorb. Writing your questions in advance helps. So does bringing someone who can listen alongside you and take notes while you focus on what is being said.
Can I ask for a second opinion before starting chemotherapy?
Yes, and a responsible oncologist will not object. A second opinion on your diagnosis, your stage, and the proposed plan is a reasonable step before beginning treatment. Ask your current team for copies of your pathology report, imaging, and any test results — you are entitled to them and will need them for the second appointment.
What if I do not understand the answer I am given?
Say so directly: I did not quite follow that — can you explain it again? Oncologists and clinical nurses expect this. If something still does not make sense, ask for written information you can read at home. Medical language is genuinely difficult, and most teams are practiced at explaining the same thing in different ways.
Should I ask about clinical trials?
Yes, if you want to know whether any are open for your cancer type and stage. A trial does not mean receiving an unproven treatment instead of a standard one — many compare two established approaches, or add a new treatment to standard care. Declining does not affect your standard care. Ask whether any are available and whether you would be eligible.
What should I tell my oncologist before chemotherapy starts?
Tell your team every medicine, supplement, and traditional preparation you are taking — Ayurvedic, homeopathic, and herbal remedies included. Tell them about any other health conditions and any previous reactions to medicines. This information changes how your plan is designed. There are no wrong answers — only incomplete ones.
Will chemotherapy affect my ability to work?
It depends on your treatment plan and the kind of work you do. Some people continue working through treatment; others need to step back for part or all of it. Ask your oncologist directly what patients on a similar plan typically find they can manage. That is more useful than a general answer, and your team will give you an honest one.
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