By Raj Mohan, MS, DNB, Mch
That the diagnosis of cancer shatters an individual and their family in many ways is a known fact. Sometimes the patient has a gut feeling that the lump is just not normal and the biopsy report confirming it comes as a mere formality. Thereafter starts the arduous journey of tests, surgery, chemo- or radiotherapy. Where to get treated, who to get treated by, and what treatment options to choose are difficult decisions to make and execute during this stressful time.
Guidance and advice comes from a lot of corners—mainly one’s immediate near and dear ones, the doctor who first gave the biopsy confirmation report, other patients or relatives, and of course the internet and the media. Difficult as the decision may be, the patient and their close ones have to move on and narrow down to one cancer treating team. Thereafter both the treating team and the patient’s team must travel together in a journey that’s bound to have its ups and downs.
In these times, when patients are bombarded with multiple opinions and Google advice, comes a unique and very subjective aspect of care: trust, or lack of trust. It would not be an overstatement to say that, like many objective parameters of cancer care such as quality surgery, optimal adjuvant chemotherapy, and standard of care radiotherapy, mutual trust between the patient’s team and the treating team goes a long way in enabling true all-around care.
Lack of trust on either side—the patient or their relatives not having full confidence in their own selected treatment team, or the treatment team’s perception that the patient is not going to follow up with their instructions—is going to hurt both the teams, especially since cancer treatment and care are generally long-term affairs. Building up trust, however, is possible. It is time-consuming and demands extra effort from both the teams—more so, obviously, from the treating team! It requires extra patience and understanding for what the patient is going through, although that is easier said than done—to place oneself in their position many times.
It is definitely worth the extra effort since it is bound to reflect in the compliance to treatment offered, the physical recovery of the patient after surgery, chemo-, or radiotherapy, the patient’s outlook on their prognosis, and, importantly, follow up. Building up trust may require multiple sessions of counseling, genuine concern for the patient’s suffering, and active participation in their care.
Even if we win or lose the battle to cancer, at the end what many patients will remember is how you made them feel comfortable as a human being, understood them, stayed with them through their ups and downs, and made them feel confident in your limited abilities but with true concern. Mutual trust to me is hence an essential component of long-term, true cancer care!
Dr. Mohan is a surgical oncologist with the Indian Air Force in Bangalore, India. He is a 2017 recipient of ASCO and Conquer Cancer’s International Development and Education Award.