Ask CancerCare
May 2008 This Month's Topic: Submit Your Questions on this Month's Topic Featured Expert: Kathy Nugent, LCSW |
Q. I have been treated by my oncologist for two years for esophageal cancer. Now my cancer has spread and I've been referred to hospice care. I'm not sure if everything has been done for me and I thought there would be more treatments available. My oncologist was so positive at the beginning and now I feel that she is avoiding me and I'm very hurt. Should I confront her?
A. Yes, you should talk to your doctor about your feelings and concerns. Don't be afraid to be honest with your doctor. Many doctors have difficulty dealing with the emotional side of cancer and they may not know how to deal with their own feelings as well as those of their patients. Decisions around treatment should be discussed with the patient and ending treatment is a decision you should make with your doctor. What are her reasons for terminating treatment? Is the decision to end treatment due to concerns about the benefits of treatment verses the risks and discomfort of continued treatment? You have the right to explore every possible medical treatment available. Have you asked your doctor for information regarding other medical treatments? Are there clinical trials that may be available to you at this time? You may also consider seeking a second opinion. These are all questions that can be part of the discussion you have with your doctor.
The Cancer Information Service (1-800-4-CANCER), through the National Cancer Institute may be a helpful resource for you. They can provide the latest cancer treatment information as well as a list of comprehensive cancer centers and clinical trials.
Another resource is the Esophageal Cancer Awareness Association. Information about diagnosis, treatment, resources and support are offered by this organization.
It can also be helpful for you to speak to someone about what you are feeling. You've developed a relationship with this doctor over the last two years and this is an understandably difficult and painful loss. It is important to maintain hope and our social workers can help you to redefine hope even when cancer treatment may no longer be an option.
Q. I'm starting to have second thoughts about my oncologist. She started off having more time to answer my questions, but over time, I feel like I can barely get a phone call returned. I don't want to be a pushy patient, but I also am becoming more and more frustrated. What should I do?
A. Your frustration is understandable. Many doctors struggle with managing time due to the increased demands on their time from patients and other responsibilities. However, you should be able to feel that you are receiving the best medical care possible, including answers to your questions. Remember, the doctor is only one member of your health care team. If you are not able to communicate directly to him or her, try talking to the nurse, nurse practitioner, or social worker associated with your oncologist's practice. At the very least, a member of the team can approach the doctor with your questions and relay answers to you directly. Prioritize and state your questions concisely. Ask how they prefer you to communicate your questions and concerns—for instance, some doctors may prefer email over a phone call.
Questions will come up outside of your scheduled appointments and it's a good idea to prioritize them. If the problem is urgent, call your doctor immediately. If it isn't, keep an ongoing list of questions for your next appointment. Make your questions clear, and make every word count.
Communication is a two-way street. It's important to be direct about the issues you have with your doctor. If you are still not satisfied with your doctor (or medical team), you have the right to change. You can ask family members or friends for recommendations and explore the doctor's communication style specifically. Remember to be consumer wise—your good health may depend on it.
If you are still feeling frustrated, CancerCare has experienced social workers who can help you more effectively communicate with your doctor. Contact info@cancercare.org or call 1 800-8130 HOPE (4673).
Q. My mother was recently diagnosed with colon cancer and is seeing a local oncologist. I'm wondering, though, if I should research oncologists or hospitals that specialize in the treatment of colon cancer. I don't think she wants to change, but I want to make sure we're doing everything possible. Should I proceed with my research?
A. Dealing with the cancer diagnosis of a loved one can be a very difficult and stressful experience. Caregivers struggle with how they can help their family member while at the same time not take over making medical and life decisions. One way you can feel more helpful is to find out information about the diagnosis, treatment and possible clinical trials. You may also suggest getting a second opinion from a specialist. It is important, however, to listen to your mother and not make the decisions for her. Ultimately, she has to feel comfortable and trust her doctor. Being able to communicate with the doctor and the medical team will help improve the quality of the care your mother receives.
Talk to your mother about your concerns. If she is finding it difficult to talk to her doctor, help her formulate questions and offer to go to her treatments and doctor visits. Often times, patients have a difficult time absorbing all that is said during an appointment, so you can be helpful by taking notes. This will not only provide support to your mother but may also allow you to feel more in control.
For more tips, see our fact sheet, "Doctor, Can We Talk? Tips for Communicating With Your Health Care Team" 
[español] . The Lance Armstrong Foundation also offers additional detailed information.
You might also want to join a support group to address some of your concerns and hear how others manage communication issues. CancerCare offers telephone, on line and face-to-face support groups for caregivers. Caring for yourself is vitally important when facing a loved one's cancer, and finding the support you need can help you feel less alone. To learn more about how to help your loved one with medical as well as emotional issues, read our Connect Booklet, Caregiving for Your Loved One with Cancer .
Kathy Nugent, LCSW is Director of Social Services for CancerCare of New Jersey. A CancerCare employee for over 25 years, Kathy has been a featured presenter at numerous workshops and seminars on the psychosocial impact of cancer, care giving and bereavement.
The questions and answers listed above are from the May 2008 Ask CancerCare feature. New Ask CancerCare topics are introduced every month.
If you have additional questions about communicating with your medical team, please contact CancerCare directly for information and guidance. CancerCare provides free professional support services, including counseling, education, financial assistance and practical help. These services are provided by professional oncology social workers. If you have a specific concern or question and would like to speak with an oncology social worker, please contact us at info@cancercare.org or 1-800-813-HOPE (4673).
For questions about medical issues, please visit Cancer.net, the patient information website of the American Society of Clinical Oncology (ASCO).
Ask CancerCare Archive (questions and answers from previous months)
| Cancer Types & Specific Populations | Emotional | Medical | Practical |
