how to speak with your doctor (when you have cancer...)

How to talk with your doctorSuzana Makowski, MD MMM FACP

Associate Director of Palliative Care in the Cancer CenterAssistant Professor of Medicine

UMass Memorial Medical Center

Friday, March 16, 12

Why talk about this?Helps you get the best care possible:

your disease and treatment

your wishes and values

your hopes and fears

your symptoms and side effects

what’s most important


Things to consider


Things to consider

How much do you want to know?


Things to consider


Everything? Nothing?


Things to consider



Who else should know?


Things to consider




What should my doctor know about me?


Things to consider




What should my doctor know about me?

Consider bringing a notebook/folder, or an organized & trusted friend

to record notes & questionsFriday, March 16, 12

Topics


Diagnosis and Treatment

What do I need to know about my disease?



What treatment options do I have?Risks and benefitsSide effectsHow should I feel?



What treatment options do I have?Risks and benefitsSide effectsHow should I feel?

What other treatment options do I have?



How will treatment affect the things that are important to me?


Dx/Tx to Sxps


Symptoms and side effects



Knowing your symptoms and side effects gives doctors clues on how best to care for you.




Untreated symptoms or side effects can drain you physically and emotionally.





The only way we know is if you tell us.



“I get so nervous”



“I don’t want to be a complainer”



“I thought my doctor already knew “



“I can’t afford another medicine”



“””I have cancer, I’m supposed to feel this way.”


Symptoms and side effects• Tell doctor or your nurse

• Write down your symptoms

• Bring a friend or family member

What kind of symptom? • pain • nausea • breathlessness • anxiety • thinking

How bad is it? • mild • moderate • severe Where is it? Timing? • constant • worse in morning/night • intermittent

What makes it better? What makes it worse?How does it effect your life, activities?





The only way we know is if you tell us.


Topics


Prognosis

• Talking about prognosis does not change the prognosis

• Most doctors wait for patients to ask this question

• Helps us plan - even when the prognosis is good


End-of-lifeWhere do you want to be?

How do you want to be cared for?

Who do you want with you?

Who can best help advocate for you?

Finding hope


Elephant to Hope


Goals of care

What’s important to me?

What am I fighting for?

What are my goals and hopes?


Finding hope:good communication means:

Partnership: doctor-patient

Optimal treatment

Personalized care

Symptom control

Dignity & integrity


Thank youFriday, March 16, 12

how to speak with your doctor (when you have cancer...)

Health & Medicine