Question: They were recently diagnosed cancer to my mother-in-law What steps should patients like her take to ensure they receive the best attention?
Answer: When my mother called me to tell me her diagnosis of lung cancer In 2017, my brain was struggling to keep up with what my ears were hearing. The phrases came in isolated fragments: “shadow in a chest x-ray“, “the doctor says I need a biopsy” and “evil one”.
Suddenly, I found myself immersed in the drama of cancerplaying an unknown role: Instead of a oncologist calmly providing information, contextualizing a diagnosis and developing a treatment planI was the son of a patient, trying to get answers.
In the following days, once the shockI helped my mother design a plan. Here’s what we came up with and what I advise my own patients to do, including a second opinion of a pathologistwhich examines the fabrics of the body to distinguish normal from abnormal.
Many patients skip this step, but errors do happen. In a study that my colleagues and I conducted through the National Institutes of Healthin which more than 900 patients with suspected myelodysplastic syndromes participated, a bone marrow cancerpathologists who are experts in this disease disagreed with the diagnosis given by pathologists who were not experts in the diagnosis 20 percent of the time.
And even more worrying, 7% of patients who received a misdiagnosis They also received a wrong treatment for your cancer. That is why it is so important to find a second opinion of a pathologistto confirm the diagnosislike a oncologistto verify the best treatment plan.
Most people learn of a possible diagnosis of cancer through someone who is not specialized in cancer. Maybe a doctor primary care raised the alarm about a lump in the breast or a blood test showed a Prostate Specific Antigen elevated, or PSA. In the case of my mother, a chest x-ray to evaluate a cough revealed a mass.
But we cannot assure that an anomaly is cancer until one biopsy confirm the presence of cancer cells. Try to stay calm until you get a formal diagnosis through additional testing.
That lump may not be cancer: In one study, patients with swollen lymph nodes and suspicion of cancer were referred by their suppliers primary care to surgeons for a biopsy. Only 17% were diagnosed cancer.
What if the biopsy sample cancer? It is normal to experience a range of emotions, such as fear, anxiety, sadness, anger or even guilt. It happened to me when I found out about my mother’s diagnosis. But before assuming the worst, ask an expert for advice on the severity of the cancer. Prepare to undergo additional tests, such as x-ray scans or even other biopsyto determine the “stage” of the cancer or how much it has spread.
I specialize in attention to people with leukemia and I have some patients who I rush to the hospital to start therapy: A study I conducted with several colleagues showed that the faster we treat that type of Acute leukemiaespecially in young adults, the longer people live.
On the other hand, I have followed other patients diagnosed with cancerlike some slow-growing chronic leukemias, for more than a decade without any treatment. In the case of my mother, the biopsy He showed lung cancer.
It’s okay to do a little research Internet before visiting a oncologistbut try not to get into too much trouble. Internet is prone to health information erroneous: one study revealed that some sites had very low accuracy in information about pancreatic cancerand another concluded that only 67% of the information about cancer shared in the social networks It was precise.
Nonprofit (such as established patient advocacy groups), government, and academic websites tended to be the most reliable sources.
When you meet with a oncologist, bring a list of questions to keep the conversation focused on what’s important to you. Bring a family member or friend to take notes and help you remember what was said.
It can be a lot to remember: When recall of the information about treatment and the side effects in 69 elderly people with cancerrespondents got only 23% of the open-ended questions correct, such as when to contact the doctor or nurse, or recommendations about food and drink.
I accompanied my 74-year-old mother to her appointment with the oncologist and I took notes on my computer. Many of my patients and their children use their phones.
Time may be of the essence and it may be difficult to get appointments quickly. So try to be flexible about who you are willing to see for a second opinionwhere can you see him (some cancer centers like mine have multiple locations) and at what time are you willing to see them. For example, my 8 a.m. shift for new patients is usually more available than my 1 p.m. shift.
In general, the cancer centers larger ones, and in particular the academic centersare more likely to have specialists in its specific cancer and be more up to date with the latest regulations diagnosis and treatment. Some even allow visits from telehealthso you can potentially watch a world expert from the comfort of your own room.
When you schedule a second opinion with a oncologistinsist that the cancer biopsy is also reviewed by the team pathology of the cancer centerwhich are also usually specialists. Often, you will have to sign a authorization for a medical center to send the sample of the biopsy to another, or even collect the sample and carry it there yourself.
When my mother looked for a second opinionhe oncologist who attended to her in cancer center where I worked did not agree with his initial diagnosticwho had determined that his cancer had spread to the lymph nodes nearby and that was in stage 3. The oncologists of the cancer center where I worked they did not agree.
They discovered that their lung cancer had not spread to lymph nodes and it was only in stage 1. Instead of needing chemotherapy, radiotherapy and surgeryLuckily for her, she only needed the operation. Behind the operationit remained cancer free and, fortunately, she is still alive and healthy.
(c) 2024, The Washington Post