Help the doctor to achieve the correct diagnosis

It is really important to describe all your symptoms and fears to the doctor. Remember that, in general, outcomes following a diagnosis of cancer are much better if the disease is picked up early.

Some people are nervous or diffident when talking with a member of the medical profession. For older people this may be because we were brought up to believe that doctors are right – a belief shared by many doctors!  Take a relative of friend with you to the doctor to help you explain your symptoms and to listen for you.

Take a relative or friend with you to the doctor. It is estimated that about 50% of information is retained accurately by patients in a medical consultation. The patient may find it difficult  to cope with information or even communicate properly when struggling with the shock of diagnosis.  Having a carer or friend present is therefore very helpful at consultations and during treatment. Hopefully, medical professionals will constantly check their listeners' level of knowledge and understanding to ensure mutual understanding and re-word, or express things differently, if necessary.

  • Describe your symptoms. It is often the case that patients do not describe their symptoms well. It can be a good idea to write these down in advance to help you discuss them with the GP or hospital doctor. It can be helpful to get someone you live with, or who knows you well, to check-over this list and come with you to the doctor to speak about anything that you miss. The doctor will be particularly interested in things like: weight loss, tiredness, any pain or swelling, bleeding, discharges and coughing. The doctor will ask you about your previous medical and social (smoking and exposure to things linked with cancer) history and your family medical history.

The bullet points below have been adapted from Groopman (2007):

  • Express your deepest fears. If you are worried about cancer, say so. As Groopman writes: 'Sometimes what you are feeling is related to what you are fearing, but the fear is so intense you are reluctant to express it, or because you think you might jinx yourself.' The doctor needs to hear that. If you think your symptoms may relate to a less common cancer he or she can explain why your symptom is not a cancer signal or refer you for hospital tests.
  • Ask the doctor constructive questions
    • What else could it be? This is a key safeguard against against errors in thinking, and encourages the doctor to re- examine the initial diagnosis.
    • Is there anything that doesn't fit? This question is to overcome what is known as confirmation bias. If a doctor draws selectively on the data that confirms a preconceived idea he or she might have discounted information that contradicted the initial theory. So by asking whether there is anything that doesn't fit, or is contradictory, it causes the doctor to pause and allow the mind to roam more broadly. When you have test results it is worth asking: do the results match the symptoms?
    • Do I have more than one problem? In medical school, doctors are often taught an ancient logic (called Ockham's Razor) which dictates that: all things being equal, the simplest single solution tends to be the best one. This is not always the case and there might be more than one thing going on. This question will prompt your doctor to consider this.
  • Don't be afraid to make return visits, ask new questions and be persistent. If your symptoms continue or the treatment you have been given is not working, the first thing you should do is repeat your story, even if you are not asked to. Sometimes, the doctor will hear something they didn't hear the first time round; sometimes you might say something you had omitted.

The Doctor - Patient relationship

Both doctor and patient should feel comfortable exchanging information (e.g. about symptoms and treatment side effects) and working together to make treatment decisions. This applies to your GP and hospital doctor.

You need to take a proactive role in your own healthcare and your relationship with your doctors.

Every doctor-patient relationship evolves and requires time and effort for both parties. There are countless reasons why tensions could arise in a doctor-patient relationship. You might feel that your doctor isn't listening to your concerns, won't answer your questions or doesn't take your fears seriously.

If it is the case, don't be afraid to tell your doctor that you feel unable to address certain issues with him or her; that you don't understand their medical language; or that you are not getting enough time to discuss your problems. For those who are uncomfortable approaching the doctor directly with a problem, ask a nurse or relative to talk to the doctor on your behalf. (Whilst some relationships may not be easy, ask yourself whether the doctor's expertise outweighs a disappointing manner?).

Most doctors want to do the right thing, and should respond well but if you continually feel that you are not getting what you need, consider asking for a new doctor.

        Sources: About.com and the American Cancer Society

 

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