Navigating a new cancer diagnosis

Ask for the pathology report, imaging results, and any biopsy findings in writing. You're entitled to all of it under HIPAA.

Having your records in hand speeds up every next step, second opinions, choosing a treatment center, and coordinating with specialists all go faster when you bring your own documentation rather than waiting on records transfers.

You can seek care at a different center than where you were diagnosed. Any major Portland-area cancer center will review your records. This is normal, expected, and welcomed by oncologists.

Portland-area cancer centers:

• OHSU Knight Cancer Institute (503-494-7999), Oregon's only NCI-designated cancer center, multiple metro locations
• Providence Cancer Institute (1-833-786-1118), multiple Portland-area locations
• Compass Oncology (503-280-1223), community-based, multiple metro locations including Happy Valley and Tigard

Getting a second opinion before starting treatment is not giving up or being difficult. It's standard practice.

Every major cancer center has patient navigators, nurses or social workers whose whole job is coordinating your care, explaining what's happening, and connecting you to financial help. They're free and you don't have to ask twice.

Ask for a navigator at your very first oncology appointment. If no one offers, say: "Can I be connected with a patient navigator?"

All major Oregon hospitals are required by law to screen uninsured patients, and patients with bills over $500, for financial assistance before billing you. Ask at your first visit. Don't wait for a bill to arrive.

OHSU covers patients up to 300% of the federal poverty level for free. Providence, Legacy, and PeaceHealth all have similar programs.

If you're uninsured and have breast or cervical cancer: ask your provider specifically about the Breast and Cervical Cancer Treatment Program (BCCTP): coverage can begin the day of diagnosis, with no waiting period.

For all other cancers: apply for OHP at one.oregon.gov or call 1-800-699-9075. If you qualify, OHP backdates to your application date.

Clinical trials aren't last resorts, they're often the most cutting-edge treatment, and participation is frequently at no cost to you.

OHSU evaluates every oncology patient for trial eligibility. You can also search on your own at clinicaltrials.gov using your diagnosis and zip code.

Ask your oncologist directly: "Am I eligible for any clinical trials for this diagnosis?"

You shouldn't be spending energy on logistics when you're in treatment. These national and local resources are free:

• American Cancer Society (1-800-227-2345): free rides to treatment, wigs, lodging help near treatment centers
• CancerCare (800-813-4673): free counseling, support groups, and limited financial assistance, national, served over phone and online
• Patient Advocate Foundation (1-800-532-5274): help navigating insurance denials and financial hardship

Bring someone to appointments to take notes. Ask for what you need.

Talk to your oncologist upfront about gender-affirming hormones if you're on them, some cancers are hormone-sensitive, and stopping HRT abruptly is not the only option. Ask for a plan that addresses both.

OHSU's Transgender Health Program (503-494-7999) can connect you with oncologists who understand affirming care. Ask them to ensure your name, pronouns, and gender-affirming medications are documented correctly in your chart before treatment starts.

🏳️‍⚧️ The Cancer Network (thecancernetwork.org) offers free virtual LGBTQ+ cancer peer support groups three times a week. Free, no registration required.