30 Something Baby Doc

There's nothing worse than telling a patient they have an agressive cancer. I had to do that yesterday.

When I get the pathology diagnosis back from the lab, I immediately rehearse in my head how I'm going to tell the patient. I strongly want to be optimistic and candy coat the situation, but when your 5 year survival is 30 - 50% there's not much candycoating you can do.

I hate being blunt and realistic but I feel it's the only way for the patient to realize what they are up against. I've seen patients in the past with unrealistic perceptions regarding their disease have horrible outcomes with no quality of life up to the very end.

I try to put myself in the position of the patient. Your sitting in the examining room waiting for the biopsy result hoping and praying that it is benign. The doctors enters, makes small talk then informs you that you have a malignancy, suddenly every priority in your life changes instantly. I see this in the eyes of patients when I give bad news and I hate it. The physician counsels the patient regarding treatment plan and prognosis, but more than likely, the patient hears absolutely nothing after the word "cancer" is spoken. It's always nice to have a family member present.

My patient handled it very well and I pray she'll be one of the 30 -50% that make it. She has the right attitude...... optimistic but realistic.