Coping with Cancer [antikvár]

Helping patients cope witn cancerPatients with cancer face the awful possibility that their disease could recur at any time, causing suffering and death. They may have to undergo radiotherapy or chemotherapy which can have very unpleasant effects like nausea, vomiting and hair loss. They may require surgery which results in the loss of a crucial body part or function. Consequently, at least one in four patients may develop an anxiety state or depressive illness, and up to a third can develop sexual problems. So it is important to try to help patients cope from the time they first present with a probable cancer.The first problem is how honest to be with the patiënt. If the doctor claims it is nothing to worry about, several difficulties can result. The subsequent rapidity of referral to a specialist and admission for tests will contradict what was said and cause alarm. When the patiënt realises he was misled he will justifiably feel bitter and begin to doubt what any doctor tells him. The diagnosis will also come as an even greater shock. So it pays to warn the patiënt from the outset.For example, the doctor might say "Ithink it'sprobably all right, but there is a chance it might be more serious. I'd like to ask a colleague of mine to seeyou to make sure." He should then add, "Is that all right?"The patiënt then has two options. First, he can elect to deny the seriousness of bis condition and seize on the comment that it will probably be all right. He may then respond by saying "That'sfine." On the other hand he can indicate that he wishes to learn more by asking, 'What do you mean, more serious?" The doctor may then take it further by explaining, "Well I'm notsure it's just a simple lump - it could be a tumour" or, "Idon't think it'sgoing to be a straighforward ulcer, you know." If he then pauses to let this sink in and asks, "Are there any questions you'd like to ask me?" he again gives the patiënt alternatives. The patiënt, of course, can still opt out by saying, "No thank you," or he can confirm that he wants to know more by saying, "You mean it could be cancer?" The doctor should then be honest but foster hope by indicating, "Well it could be, that's why I'd like to be sure. But even if it is, we should be able to do something about it." In this way the doctor facilitates coping by tailoring what he says to what the patiënt wants to know.The next critical stage comes when the diagnosis has been confirmed by the tests, and the same procedure should be followed to establish just howHelp