Overcoming the Cancer Fear Factor
William J. Charles, MD
As an oncologist, I am frequently confronted with anxious patients who do not know why they are seeing me. Many of these patients, after arriving at my office may see other patients who are much sicker, may be carrying infusion pumps, or are simply too weak to stand and must use wheelchairs or stretchers. These visuals can be very daunting and no doubt for some initial patients, traumatic.
In my almost ten years of practice, I have always felt the best patient is one who is at ease during the visit. A patient who is comfortable and not gripped with fear is able to give a good history which is pivotal in making a diagnosis. The question becomes: How does someone who has been told they may need to see a Medical Hematology/Oncologist, prepare for that visit?
Here are some key questions and answers that may help in making the visit less anxiety provoking.
What are the results of my test and what does it mean?
Knowing the results of the test that prompts a referral to the Hematologist/Oncologist is the first step to curbing one’s anxiety. Many times I am confronted with a terrified patient with borderline labs, who thinks they have a life threatening condition. They are usually relieved when told by me it is not. However the toll of anxiety could have been much less if the questions, “What does this mean?”, and “Is this serious?” are asked of their primary doctor.
What is a Hematologist/Oncologist?
A Hematologist/Oncologist is a physician that specializes in the care of patients with cancer or blood disorders. To the lay person, the word Hematologist/Oncologist often signals cancer, terminal illness, and death. That is why the answer to the first question is so important. As doctors who take care of cancer patients, a large part of our role does indeed involve diagnosing, treating and counseling our patients, some of whom succumb to their disease. That said, some of our patients do improve, go into remission and certainly some are cured.
Our role entails taking care of blood disorders, many of which are benign (non-cancerous), or chronic (long-term), and can simply be observed. Every new patient should know that Hematology/Oncology does not always mean cancer or death.
Why do I need to see the Hematologist/Oncologist?
Know the reason why you have been asked to see the Hematologist/Oncologist. Your primary care physician will know why they are sending you to see a specialist. It is very important that patients ask their doctor their thoughts about why they think a referral is necessary. The role of the Hematologist /Oncologist is to offer further expertise about a suspected illness, and to suggest the most effective treatment plan if needed. Making sure that there is not an underlying cancer or blood disorder as a cause of illness is another reason why you may be asked to be seen.
Some patients may feel a little ambivalent when referred by their primary care physician to a specialist. However, it may be that your primary care physician cannot perform all of the testing necessary to establish an appropriate diagnosis. It is important to recognize that the mark of a good physician is one who knows when to summon assistance in the appropriate diagnosis and treatment of a possible blood disorder or cancer.
What should one expect on an initial visit?
To many, coming to the Hematology/Oncology office can be a fearful experience. Having an idea of what to expect in the waiting room may be a great start. This can be asked of your primary care physician or by calling ahead to the specialist’s office. Indeed one may be confronted in the waiting room by patients that are quite ill, and in some cases, may only have weeks or days to live. Others may be wheelchair bound due to weakness, some appearing pale or with alopecia (hair loss), while others may be experiencing pain and discomfort. There will be those who are ill, but comfortable. Being able to anticipate the full spectrum of patients you may encounter will not only help you prepare mentally for your visit, but it will also help to put any potential disease you may have in prospective.
Should I bring someone with me for the visit?
Seeing a Hematologist/Oncologist for the first time can not only be nerve racking but can also be a lonely experience. If at all possible, bringing a family member or friend to the first visit is paramount. Many patients are so nervous that they miss some important points that were discussed. Given the complexity of the discussion, including diagnosis, prognosis, and treatment, having a family member or friend not only lends support but may help in remembering the discussion and generating questions to ask at a later visit.
Is there anything I must bring on my visit?
In most cases, if all of the previous recommendations are followed, then you will have 90% of what you need to bring taken care of. The most important person is you and how well you are able to convey how you feel and what your ailment is. In most cases, one should not worry about bringing test results unless they have been instructed to do so prior to the visit. Many previous tests and records are easily obtainable even if they must be retrieved while the patient is being seen.
Following these recommendations can help in making a visit to the Hematologist/Oncologist a less tense and frightening experience. I encourage all patients to be proactive and to ask questions so that you understand the role of any specialist you may be referred to.
Dr. William J. Charles is a board-certified Hematologist/Oncologist.