Diagnosis Date: __/__/____
Diagnosis: _____________________________ Stage: _____________ Grade: ________________
Additional Information: __________________________________________________
Doctor’s name and contact information:
__________________________________________________
What treatment or combination of treatments are available in my case?
How long does each treatment take? Will I need to be hospitalized?
Do we have to look for experimental treatment or it is too early?
Will more tests be necessary to select the best treatment option?
How is treatment selection affected by my other medical conditions or medications?
Are supplements helpful? Are they safe?