ELSHAMI M. ELAMIN, MD Medical Oncologist CENTRAL CARE CANCER CENTER Living and Coping with cancer
INTRODUCTION • When doctor says the word “cancer”: • People can be overwhelmed • Cancer diagnosis often brings: • Disbelief • Sadness • Anxiety • Anger • Feelings of fear • Confusion • Feelings of helplessness
INTRODUCTION • Cancer diagnosis may lead to a change in: • Person's priorities: • Relationships • Career • Lifestyle
COPING WITH CANCER • WHAT CANCER PATIENT NEEDS? • Help to answer common questions about cancer. • Help to feel more in control of his/her health.
When you meet your health care team: • Learn the medical terms • Will help making informed decisions about cancer treatment • Ask for a simpler explanation when don’t understand something • Ask to see: • Drawings • Pictures • X-Rays
Seeking information • Understand your disease • Process of diagnosis • Treatment options REMEMBER: During the initial visit, absorbing the news of the cancer and its unfamiliar medical language may be difficult and overwhelming
When you get home: • Try to take care of yourself while coping with this news • Start learning about your disease • Seek the support of family, friends, and others • Find other ways to express your feelings • Write down your questions for the next doctor visits
GET ORGANIZED • Because: • In a short period: • Various doctors’ visits • Gather a large amount of paperwork • Test results • Personal notes • Talking to insurance Create a system
Back again to see your health care team: • Ask your questions again • May bring a family/friend • Not only be supportive, but can also help listen to and remember information
Being an informed, involved patient is helpful to you and your health care team in forming a partnership in your care. • Tell them how you prefer to be given information about your diagnosis, treatment, and prognosis. • Don't be afraid to ask questions or to let your doctor know that you don't know what questions to ask.
The following questions may be appropriate to ask your health care team: • What is the exact type and name of the cancer I have? • How was it diagnosed? • What tests were taken and what did they show? • Will I need additional tests? • What stage is the cancer and what does that mean? • What are my treatment options? • What are the possible side effects of this treatment option, both in the short term and the long term? • What clinical trials are open to me? • Who will be coordinating my overall treatment and follow-up care? • Who will be part of my health care team, and what does each member does? • If I’m worried about managing the costs related to my cancer care, who can help me with these concerns? • What support services are available to me and my family?
Second opinion • A second opinion is standard practice in medical care
Understanding your emotions • Illness changes our relationship to the world. • Remember: • There will be days when you cannot make yourself feel hopeful. • That is normal, especially if you feel physically sick or tired.
Get support • Sharing fears and anxieties with family or friends, counselors, support groups: • Strengthen patients emotionally, and perhaps even physically. • However, some may express their feelings in other ways: • Writing • Reading • Painting • Praying • Anxiety and depression: • If you find yourself not interested in normal activities for more than a few weeks, talk to your doctor.
Fear of recurrence • Maintain your schedule of follow-up visits • Many cancer survivors describe feeling scared and nervous • These feelings may ease with time • To reduce a anxiety: • Discuss with your doctor: • The actual risk of recurrence • The symptoms to report
Health care provider ROLE OF HEALTH CARE PROVIDER
“Doctor’s most difficult duties” • Breaking Bad News: • Confirm medical facts • Review relevant clinical data • Arrange adequate time • Privacy • Allow for Questions • Allow for silence and tears • Emotionally prepare for the encounter • offer realistic hope
Breaking Bad News • Keep in mind: • Socio-cultural differences: • Family barrier • What and how much information is provided • Participation in medical decision-making • Asian pts prefer: • Relatives be present more than Westerners do • To discuss their life expectancy less than Westerners • Religion and believes
Breaking Bad News • Patients' preferences for communication: • Differ based on: • Gender • Age • Level of education • Younger, female, highly educated patients desire to receive: • As much detailed information as possible • Emotional support
After the bad newsDoctors first focus on: • The physical effects of the disease • Treatment
Treatment options: • Help patients make more informed decisions about their health care • Patients also should know the short-term and long-term side effects of their treatment to anticipate how their needs may change in the future.
Caring for the Whole Patient • The health care team should address the psychosocial effects of the cancer: • Lack of information and support • Emotional difficulties • Depression and anxiety • Lack of transportation • Disruptions to work, school, and family life • Paying for medical bills
Emotional support • Patients with untreated depression or anxiety: • Less likely to take their medication • More likely to withdraw from family and others offering support
Emotional support • Resources and services: • Peer support groups (Victory in the Valley) • Individual or group counseling • Medication
Lifestyle changes • Part of cancer treatment plan may includes: • Change in lifestyle and habits • Change in physical activity levels • Change in diet • Quit smoking
Managing life disruptions • Change in work schedulesor stop working • The Americans with Disabilities Act and the Family and Medical Leave Act provide legal protection for disruptions in work due to cancer treatment • Trouble performing daily activities • Home care
What to expect after completing treatment • What treatmentpatient received • Schedule for follow-up • Learn the definitions of medical terms • Keep a complete record of medical care • Manage Side Effects