Questions to ask your child's oncologist — what every parent needs to know

The single most useful question at a first meeting is: "What is the exact name and subtype of my child's cancer, and how does that change the treatment options?" Childhood cancers look similar under a microscope but can behave very differently based on their molecular subtype — that subtype drives which treatment protocol is used and how long treatment lasts. Once you know the precise diagnosis name, you can also understand the information your care team shares, and prepare more focused questions for every appointment that follows. Ask the doctor to write the diagnosis down clearly so you have the exact terminology to refer to.

A recommended treatment plan for a childhood cancer should be based on an agreed international protocol — most centres follow evidence-based guidelines such as those from the Children's Oncology Group (COG) or the International Society of Paediatric Oncology (SIOP). Ask your oncologist which protocol is being followed and why it was chosen for your child's specific subtype and stage. At CION Cancer Clinics, every child's case is reviewed by a multidisciplinary tumour board before a plan is recommended — meaning no single doctor decides alone. You are always entitled to ask for a second opinion; this is a reasonable and accepted step that most oncologists support.

This is one of the most practical questions to ask before treatment begins. Ask your oncologist or specialist nurse to give you a written list of the specific side effects expected with your child's treatment, and a clear set of symptoms that mean you must call the team immediately — regardless of the time of day. Common 'call now' situations include: fever above 38°C during treatment (this can indicate infection requiring urgent assessment), any unusual bleeding or bruising, severe vomiting that stops your child from drinking, or any sudden change in your child's behaviour or level of alertness. Ask for a 24-hour contact number before you leave the hospital.

This varies considerably depending on the type of cancer and the treatment being given. Some treatment cycles — particularly the first round of therapy — often require a hospital stay for monitoring. Later cycles for many cancers can be given as day visits, with the child returning home the same day. Ask your oncologist at the outset which parts of your child's plan are inpatient and which are outpatient, and roughly how long each phase lasts. This helps with practical planning — especially for families who need to travel to reach the treating centre, arrange care for other children, or manage employment. The CION team can also connect you with travel and accommodation support where needed.

During treatment your child will have regular assessments — blood tests, scans, or bone marrow checks depending on the cancer type. These are scheduled at specific points in the treatment protocol and tell the team whether the cancer is responding to the current approach. Ask your oncologist to explain what response means in your child's case: is the goal to see the tumour shrink, for blood counts to normalise, or for cancer markers to fall? Also ask what happens if the response is not as expected — knowing there is a plan for that situation helps many parents feel more in control. The care team will explain these check points when they share the overall treatment timeline.

Some treatments for childhood cancers can affect a child's growth, hearing, fertility, or learning — depending on the type of cancer, the parts of the body treated, and the child's age at the time. This area of medicine is called late effects, and most specialist paediatric oncology centres monitor for them during and after treatment. Ask your oncologist which late effects are relevant for your child's specific diagnosis and treatment, and how the team plans to monitor for them. This is an important question to ask early — some protective steps (such as fertility preservation discussion for older children) need to be considered before treatment begins, not after.