Cancer: In The Doctor’s Cabin

Most of us have faced interviews sometime or other in life. The interview can be for job, admission to school or college, talent hunt, and passport or visa application. We all go prepared and we are ready with probable questions and answers. If one is an interviewer, then one is ready with the questions one wants to ask for making informed balanced decision.

When you are in Doctor’s cabin, at first it is doctor’s turn to be the interviewer. Doctor will ask questions to get all relevant information; he / she will go through all reports, lab findings which are like resume. The doctor reaches to informed, balanced decision and the diagnosis is made. At this point, the roles change. Here onwards, patient becomes interviewer. It is doctor’s duty to clarify all doubts in patient’s mind and they all are willing to perform their duties; but it is patient’s responsibility to bring all his doubts to the doctor’s notice. Most of the visits to Doctor’s cabin are for simple cough, cold, joint pains or fever, but some of us have to be there for reasons much more sinister than that.

It may start as a simple persistent cough, bad bowel habits, and unexplained loss of weight, disturbed urination, bone pain or some lump somewhere. Then there are tests, scans, markers, and biopsies. At the end of this, one is in doctor’s cabin and the verdict is what one fears the most. All the same, doctor says, “No need to worry. There is problem but science has made tremendous progress and there are good chances of full recovery. We shall start the treatment immediately”.  The patient looks at heaven, to accompanying relative or friend and again to doctor and he says to the doctor, “All right, let us do what we can and hope for the best”. At this point, I feel patient should ask for ‘Time Out’. The ‘Time Out’ can be 1-2 hours or few days. The time is needed for changing role from being interviewed to being interviewer. The time-out is needed to understand the situation and to gather all possible information.

The cancer information is freely available on internet. One can use this tool to gather information. One can consult other doctors to take second opinion or discuss the situation with whom or whose close person has been through the same situation. One can even visit public library to get detailed information. Spending few days in getting such information is not likely to cause any harm. This in-depth information is also necessary to understand the answers which doctor is going to give to one's queries.

All patients must know answers to following questions:

1.    What is the type of cancer and has progressed to which stage? Cancer is not one single disease. Knowing the name is first step in knowing the enemy. Medical science has scientifically classified all cancers in ‘4’ stages depending on progress of disease and chances of cure.

2.    Is the diagnosis 100% correct or there is need of doing any other additional tests, investigations before starting the treatment? Normally not doctor will be give ‘Cancer’ verdict unless being 100% sure, but it is better to ask. It is also better to confirm that there is no computer mistake or clerical error. This is necessary because these doubts will always be lingering in minds of patient. The clarification of all doubts is really necessary for waging full fledged fight against disease.

3.    Is the cancer Non-Invasive or Invasive, and the speed with which is it expected to spread if untreated?

4.    What manner of the treatment will slow down or cure the disease?

5.     What are expected stages as disease progresses or gets cured?

6.    What is the percentage of occurrence of this type of cancer in our society? This is purely academic question but it helps to know that one is not the only unlucky one.

7.    What is going to be the line of treatment?  There are mainly three types of treatments which a doctor will consider. Chemotherapy, Radiation or Surgical. Cancer doctor may choose to opt for only one type or may opt for combination of two or all three. Patient must ask for reasons for doctor’s choice and must confirm that doctor is expert in all three types of treatments. There are various drugs available for treating each cancer. It is necessary to know why doctor has chosen the particular drug therapy. It is sadly noticed that often there is unhealthy tussle or competition between oncologists and onco-surgeons. In order to protect his own interests, patient must get opinion from all fields. Also, one must ask if there is any other treatment available such as hormone, stem cells etc.

8.    What are going to be the side effects of the treatment? This the most troubling question in all those who are going to have cancer treatment. All scientists, chemists and doctors are relentlessly trying to create newer molecules with the least side effects. Modern therapies have comparatively lesser side effects.

9.    Is there any other therapy with proven results in treating similar cancer? Is the alternative medicine treatment likely to interfere with therapy prescribed by the doctor? There are many claims of treating various cancers with help of plant extracts and alternative medicines. These are mainly instances where patients are seen to be cured with these methods.

10.  Are there any drugs which are in experimental stage? Is it advisable to participate in such experiments? What are the risk factors?

11. Who is the most reputed doctor or is considered the ultimate authority in treating similar cancer?

12. Which are the medicines prescribed by doctor for treating the symptoms of the disease?  It is important to know which drugs are given only for treating symptoms and side effects of treatment and which drugs should be taken if symptoms become very severe and unbearable.

13. Which part of the treatment can be taken at home and which parts needs hospitalization and what is the duration of hospitalization?

14. What is likely to be the cost of treatment in worst and best case scenario? Patient must get full information of cost involved in various regimes along with pro and cons of these regimes. This helps patient and relatives to take decision about the line of action.

15. What changes are needed to be made in life style, in relation to diet, exercises and other habits?

16. Which food supplements, vitamins and nutritional agents are needed to keep mind and body at maximum possible efficiency?

17. What is percentage of totally cured cases and what percentage cases have beyond ‘5’ years survival?

18. How to monitor progress of cure? It is important to know if the disease is getting controlled by noticing changes in symptoms and by diagnostic means.

19. What are the ways to contact doctor in case of emergency or if there is any query or if any advice urgently needed? Whom to contact in case doctor is not available? It is better to note down doctor's residential phone number and phone numbers and timings of all clinics, hospitals he/she must be visiting. 

Never ask what one could  have done to avoid the tragedy? This is useless question as it relates to past which one cannot change. No need to have guilt-trips.

Take second opinion, may be third, till one is convinced that this is the best line of treatment. It is necessary that one must be sure of getting the best treatment. This will help one in having positive approach leading to better immunity and will help body become synergistic with the treatment.

There can be a situation where answers to the very detailed inquiries can be the worst and patient might come to know that there are not many days left for him/her on this earth. In such cases as well, it is necessary that patient knows the facts. The initial reaction of the patient might be of shock and sorrow, but patients soon overcome that and plan to finish unfinished jobs in the days available. The majority of these patients live these remaining few days in a very determined manner and actually give support to loved ones who are emotionally broken down.

I am not a doctor nor am I a cancer patient at present; but I have accompanied number cancer patients to doctor’s cabin. I have seen the dilemma and confusion in minds of patients, relatives and friends after hearing cancer verdict. This has prompted me to write my thoughts.

Happy Mind Is Healthy Mind