Preparing for your visit

Why preparation matters

An oncology consultation is not like a routine GP visit. The doctor needs to look at the full picture — biopsy findings, scans, blood work, and the medical context around them — before recommending a treatment plan. A complete file in your hands at the first visit can save you weeks of repeat tests and a second appointment to "come back when the reports are ready". Spend half an hour gathering things the day before, and the visit itself will be far more productive.

"The single biggest reason a first visit ends without a clear plan is missing information. Slides not collected from the lab, a scan CD left at home, the name of a previous chemotherapy regimen no one wrote down. Bring everything."

What to bring — the essentials

The full checklist

1. National ID card (CNIC) — required for registration.
2. Insurance card or panel letter, if you have one.
3. Referral letter from your GP, surgeon, or previous specialist, if you have one.
4. Discharge summaries from any related hospital admission.
5. Biopsy report (histopathology) — every page.
6. Immunohistochemistry (IHC) report, if done.
7. Molecular / genetic test reports — HER2, hormone receptors, EGFR, ALK, BRCA, MSI, NGS panels, etc. — if any have been done.
8. Unstained slides and paraffin blocks from the biopsy or surgical specimen — collect these from the original lab.
9. All CT, MRI, PET-CT and ultrasound CDs or USB drives, along with the written reports.
10. Mammogram films or CD, for breast cancer patients.
11. Bone scan or DEXA scan reports, if relevant.
12. Recent blood reports — CBC, LFT (liver), RFT (kidney), electrolytes, tumour markers (CA 15-3, CA 19-9, CA 125, CEA, PSA, AFP — whichever apply), hepatitis B and C, HIV.
13. Echocardiogram or ECG, if recently done.
14. A complete list of current medications with doses — including supplements and herbal remedies.
15. List of allergies — drug, food, contrast.
16. List of past surgeries with approximate dates.
17. Names and contact numbers of previous treating physicians — surgeon, radiologist, pathologist, prior oncologist if any.
18. A close family member to come with you and take notes.
19. Your questions, written down, in the order they matter most to you.
20. A notebook or your phone to write down what is discussed.
21. Bottled water and a small snack if you are diabetic or are coming from far away.

How to collect slides and blocks from the lab

If a biopsy was done at a hospital or private lab, the histopathology department keeps the paraffin blocks and original slides on file for several years. To collect them:

• Visit the lab in person with a copy of the biopsy report and your CNIC.
• Ask for the paraffin block and a set of unstained slides (usually four to six slides). If they ask why, say they are needed for review and possible further testing at another oncology centre — this is a routine request.
• You may be asked to sign a release form. There is usually no charge, or a nominal one.
• The block and slides will be released in a small labelled box. Keep it cool, away from direct heat — but no refrigeration is needed.

How to copy imaging to a CD or USB

Most radiology centres can give you a CD with your scan images on it within an hour of the scan. If you've misplaced an old CD, go back to the centre where the scan was done — they keep digital copies and can re-burn one for you, usually for a small fee. Some centres can also email you a download link.

For modern scans, a USB drive is more useful than a CD because many laptops no longer have CD drives. Either is acceptable.

Writing down your questions

When you are anxious, even simple questions slip out of your mind in the consulting room. Write them down. Don't worry about whether a question is "silly" — there are no silly questions in oncology. Some common ones to consider:

If you've been treated before

If this is a recurrence or you've already had treatment elsewhere, please also bring:

• The names and doses of any chemotherapy, immunotherapy or targeted therapy you've received — and the dates.
• The radiation dose, the area treated, and the dates, if you've had radiation.
• The operation note from any cancer-related surgery.
• Any scans done before, during, and after your previous treatment — so we can see the trajectory.
• The name of your previous oncologist, and a way to contact them if we need to.

One last thing — bring yourself, rested

If you can, eat a normal meal beforehand, get a full night's sleep the night before, and don't schedule anything important right after the appointment. A cancer consultation is emotionally heavy. Leave room in your day for the conversation to land.