What to Ask Your Doctor After a Lung Cancer Diagnosis

Let’s make it simpler. To be honest, early on, the aim isn’t to ask everything. It’s to get a plan, a timeline, and a number to call.

Before we get into the questions, it helps to know what we are trying to achieve in that first stretch after diagnosis. We are not trying to solve everything in one appointment. We are trying to get clarity on three things: the diagnosis, how far it has spread, and what happens next and when. Once those are clear, everything else becomes more manageable, including the decisions.

If it helps, do these three things:

• Bring a list of your medications, allergies, and any important medical history.

• Take someone with you, or ask to record the conversation on your phone.

• Ask for a written summary of the plan, even if it is brief. Memory is not at its best when you are stressed.

Why Should We Ask Questions About Our Diagnosis?

Below are the questions I would want you to have on hand when you speak with your physician. Use them as a checklist to understand your situation better. Pick the questions you think apply the most and write your doctor’s answers down.

If you can, bring someone with you, not to speak for you, but to listen, take notes, and help you remember what was said, and to make sure you leave with a clear next step and a contact number.

1) “What exactly is the diagnosis?”

You deserve to understand what is happening, not hear vague labels. Ask the following questions to get a clear picture of what you’re facing:

• What type of lung cancer is it? (Non-small cell or small cell, and the subtype if known.)

• Are we certain it started in the lung?

• What is the diagnosis based on? (Biopsy, cytology, scans.)

• Do we have enough tissue from the biopsy, or might another sample be needed?

• Has the plan been reviewed by a lung cancer specialist like me? If not, can it be?

Why this matters: treatments differ massively by cancer type and subtype. Getting the label right is not just paperwork. It changes everything.

2) “What stage is it, and how confident are we?”

Staging is simply a map. Where it is, and where it is not.

• What stage is it right now?

• Has it spread to my lymph nodes? If yes, which ones?

• Has it spread anywhere else? (Common areas include the bone, liver, adrenal glands, and brain.)

• Is staging complete, or are we still waiting on scans?

• What is the timeline to finish staging and make decisions?

Here’s a small but important point to remember: Sometimes the stage is “provisional” until one last scan comes back. That is normal. You just want to know where you are in the process.

3) “Are we doing the right tumour testing?”

This is one of the most common places people get short-changed, usually by accident. To be honest, it’s worth being politely persistent about certain steps to be taken:

• Will my cancer be tested for actionable mutations? (This is especially important for non-small cell lung cancer.)

• Will we have PD-L1 testing? (PD-L1 is a marker on tumour cells that can help guide whether immunotherapy is likely to be helpful, and how it might be used in your treatment plan.)

• Do we have enough tissue to run all the tests?

• If tissue is limited, should we consider a liquid biopsy? (A blood test that can sometimes detect tumour DNA.)

• How long will these results take?

• Are we waiting for these results before starting treatment? If not, why not?

These results can open the door to targeted therapies and can completely change first-line treatment choices. It is worth being politely persistent.

4) “What is the aim of treatment in my case?”

This question sounds heavy. It is also grounding. You have to find out about the following:

• Is the intent curative, long-term control, or symptom control?

• What is the best-case scenario here?

• What is the most likely scenario?

• What would you recommend if I were your family member?

Remember that you are not asking for false certainty. You are asking for honest framing. Your doctor should know that the answer is important to you.

5) “What is the plan, step by step?”

Even a brilliant plan is stressful if it is vague. You have to know:

• What happens next, in order?

• What are we waiting for before treatment starts?

• Who is coordinating this?

• When will my case be discussed at the MDT? (The multidisciplinary team meeting.)

• When will I see you next, and what will we decide then?

If you leave with nothing else, leave with a timeline.

6) “What treatments are on the table for me, and why?”

This depends on the stage and cancer type. Still, the questions stay similar, in whatever stages:

If it is an early stage (often stage I to II)

• Am I a surgical candidate?

• If surgery is planned, what operation and why? (Wedge, segmentectomy, lobectomy.)

• If not surgery, is SABR (stereotactic radiotherapy) an option?

• Will I need treatment after surgery or radiotherapy (chemotherapy and immunotherapy, targeted therapy)?

• What does follow-up look like after treatment?

If it is locally advanced (often stage III)

• Is the plan chemotherapy with radiotherapy, surgery, or both?

• What is the goal of treatment here?

• Will immunotherapy be part of the plan after chemoradiotherapy in my situation?

• What are the main risks, and how do we reduce them?

If it is metastatic (stage IV)

• What is the best first-line treatment for me and why? (Targeted therapy, immunotherapy, chemo-immunotherapy, chemotherapy.)

• What would make you choose one option over another?

• What is the plan if this first treatment stops working?

• Are there clinical trials I should consider now, rather than later?

And one useful question that often gets missed:

• If most diseases are controlled, but one area grows, can we treat that spot with radiotherapy and keep the systemic treatment going? (This can be relevant in oligoprogressive disease.)

7) “What side effects should I actually look out for?”

People often get a long list. It’s not always helpful, especially when they don’t understand what the list is all about.

• What are the common side effects, and how do we manage them?

• What are the rare but serious side effects that mean I should call urgently?

• Who do I call out of hours?

• How often will I have blood tests and scans?

• What should I stop doing, if anything? (Work, driving, travel, gym, supplements.)

If you are on immunotherapy, be especially clear on which symptoms are “don’t wait” symptoms, because immune-related side effects can escalate if ignored.

8) “Can we deal with my symptoms properly, now?”

Symptom control is not a luxury. It is part of good cancer care.

• What is causing my breathlessness or cough?

• Do I need inhalers, antibiotics, steroids, or chest physiotherapy?

• If you have pain: what is the pain plan, and who reviews it?

• If fluid is present around the lung (pleural effusion), do we need to drain it, and what are the options if it comes back?

You may hear “palliative care” mentioned. That does not mean end-of-life. It often means specialist symptom control and support. Done early, it can make a big difference.

9) “What should I do between appointments?”

The in-between period is where anxiety thrives.

• What symptoms should prompt a same-day call?

• What can I do to stay as well as possible during treatment?

• Do I need vaccines or infection precautions?

• Should I stop smoking, and what support can you offer?

• Is pulmonary rehab, physio, or dietitian’s input available?

And yes, ask about sleep and anxiety. You are not the first person to struggle with it. You will not be the last.

10) “Do I need a second opinion?”

Second opinions are normal in diagnosing lung cancer. It is not an insult to your previous physician. It is just due diligence.

• Would a second opinion add value in my case?

• Who would be best placed to review it?

• Will it delay treatment?

• Can my scans and pathology be shared easily?

Good clinicians do not feel threatened by this. They often even encourage it.

11) “Who is my point of contact?”

This sounds mundane, but it’s one of the most important questions.

• Who do I contact for results?

• Who do I contact if my symptoms change?

• Is there a lung cancer nurse specialist (CNS) involved?

• How do I reach someone quickly if I am worried?

You should not have to guess who to call.

Here’s a Short List, if You Are Too Tired for the Full Version

If you can only ask a handful of questions, make it these:

• What type is it, and are we sure?

• What stage is it, and is staging complete?

• What biomarker tests are we doing, and when will we get results?

• What is the aim of treatment for me?

• What is the plan, step by step, and what are the timelines?

• What do I do if symptoms worsen, and who do I contact?

You do not have to do this perfectly. You do not have to be brave, organised, or calm. All you need is a plan you understand, and a team you can reach.

Remember - it’s not your job to ask any of these questions! You just need a team that inspires you - that you know are doing all that needs to be done to get you the care you need.

About Dr. James Wilson

Dr. James Wilson is a consultant oncologist specialising in lung cancer and advanced radiotherapy. Based in Central London, he works full-time in private practice, aiming to provide rapid diagnosis, clear plans, and calm, practical guidance when time matters.