What is the best way for a doctor to tell a patient he has cancer?

I've been thinking about the original question for about 5 more minutes and what popped into my head was:

Q: "What is the best way for a doctor to tell a patient he has cancer?"
A: Quickly

It's a punch to the gut, just say it, get it over with.

81GyGuy said...
So what is the best way for a doctor to tell a patient that he or she has cancer?

I suppose that can range all the way from

"You have advanced cancer. I don’t think you'll live more than another few months. I'm sorry."

to

"Yes, it's cancer, but please realize there's a lot we can do. For example … (positive discussion continues)."

Doctors are going to vary on this. I rather liked the way my own uro broke it to me back in 2011 at my own PCa diagnosis:

"Well it looks like you do have a little bit of cancer in there."

Everything in that statement is compact, in one sentence, and the phrase "little bit," with the suggestion that there is indeed hope, is right there with "cancer," and even precedes the word "cancer," sort of delivering the good news first.

I thought that was well done.



The article below, though a bit old, still makes some good points on how doctors can effectively relay this bad news to their patients, if that's what they have to do.

HIGHLIGHTS:

"… most medical schools don't offer students any formal
instruction in breaking bad news, and physicians often have to devise their own methods."

"… doctors rank discussing a recurrence of cancer with patients as one of the most difficult tasks they perform."

"Doctors are taught that in order to apply their technical expertise, they have to be detached emotionally, but patients may experience this aloofness as insensitivity."

OTHER: if possible, discuss face-to-face, not over telephone. Doctors should not overuse technical language. Doctors must LISTEN more. ("Studies have shown that in an average office visit, patients talk a mere 18 seconds before their physician interrupts them. Less than a quarter of patients even get to finish their opening statements"). Also, let patients vent if they need to.

And one rather interesting perspective:

"… Physicians should never say "We got it all" after a course of treatment. This sort of pronouncement implies that the patient has been cured of cancer, an overstatement that can come back to haunt both the patient and doctor if the disease recurs. A better phrase would be "We got everything we could see at this time."

www.cancernetwork.com/articles/how-doctors-break-bad-news

Of course delivery of a diagnosis can be tailored to the individual patient's temperament, if the doctor knows what that is, but, in general, how should doctors deliver a cancer diagnosis?

What do you think?

My Urologist told me, and also mentioned she was sure it was outside my prostate. I told her to please be blunt, no sugar coating it. This is the way I personally prefer it though.

Mike

I took a class for work years ago called"the change cycle" about how to get people to accept rapid change.
On rapid change like a cancer DX or getting fired the brain goes into it's reptilian state, all rational thought shuts down and it cannot focus on solutions or information. Giving out lots of information at this time is not productive, because the brain can't absorb it in it's current state.
The best way to move from this state is to have the individual do research on options rather than focus on his problem. For example when firing someone offer options like: do you want a lump sum severance or would you like your medical insurance covered for X months, think about it and get back to me next week.
For a cancer DX there are a lot of options you can give a patient to get him researching solutions rather than focusing on his cancer. This has always worked well for me. Complex information can be given at a later date when the individual is better able to process it.

Here's a relevant variation on the original question:

Q: What is the best way for a doctor to tell a patient he has favorable-risk cancer?

What's the best way to help patients NOT enter a "cancer hysteria" thinking that they need to "get it out now!!?" What's the best way to help low-risk PC patients understand that there is no benefit to immediate treatment...and if they wait to confirm whether they need treatment or not, they may be among the sizable population that actually never needs treatment (and it will not "cost" them anything in terms of eventual cancer outcomes to see)?

I say it's relevant because more than half of all new PC diagnosis is favorable-risk. More than half of the readers of this thread fall into that category (if our self-selected sub-group mirrors the general population in the U.S.).

Just today, I read two amazing comments. One was by a member diagnosed low-risk who said he had treatment because a follow-up, confirmatory biopsy (which he didn't have) "could" have come up with something other than 3+3. Another member said a key reason for his treatment was because it cost him little or nothing. Hey, call me crazy, but these are NOT well reasoned. Unfortunately, both these gentlemen had already had surgery (in both cases), but if you met someone before treatment who said either of these to you...you'd say, "Wait a minute. Let me help you understand this thing a little better, cuz your diagnosing doctor obviously did a sh!tty job explaining things to you." You'd say that, wouldn't you?

Maybe this very relevant variation of the original question should be it's own thread...

Post Edited (NKinney) : 5/2/2018 6:42:27 PM (GMT-6)

Saipan You...that would be you as an individual...said the same thing... on the thread earlier.... and while the posts have all been insightful and fun...the thread title says what the thread title says...YOU say the whole point is to blah...blah blah...you can not apologize to some one who has made the point of his question...and then dismiss his point and substitute your own...well I guess you can...as you just did...again...Unless you are saying that it was asked in a positive way to get a negative response so as to get a positive response for some of the posters who really wanted to tell their stories...lets get this clear...I loved their stories...but words really do matter...you just can/t make stuff up so as to win an argument...don't straw man me...we see enough of that in daily repartee} this statement is not rocket science...a person just has to listen to the points made...then thru an act of will stay on point...that way...civil progress is made...there are arguments in a court of law to get the truth...stay on point...and there a debates to "win" {truth be dam} 2 entirely different species...I do realize that todays courts partake in the latter today as well...it was not always this way...it will get worse ...as we see all around.... in every venue of life...back to a delight and insight full thread

Logo....we need to give Saipan some latitude. He is a lawyer after all, and like me, is suffering the pangs of ADT right now.

I agree with SP. it’s highly likely that there are no doctors here reading the posts. So th equestrian posed is a worthwhole one, but for entertainment. It’s not going to change how any of our doctors transmit the bad news