Doctor Patient Relationship in Cancer – Does It Make A Difference?

The doctor-patient relationship matters especially in cancer patients.  That has always been my theory based on emails I receive from breast cancer patients.   The women who tell me they love their doctors, trust their doctors, and feel confident that they are placing their lives in their physicians’ hands, always seem like they are doing better emotionally and even physically through cancer treatment and beyond.  Often, when I get a letter from a woman who is really having a rough time, I ask her how her relationship is with her Oncologist or Surgeon.  Nine times out of ten, they admit to me that their confidence level is low, and they have thought about changing doctors but are afraid to do so. Now I have a study to prove my theory:

Lacking trust in one’s doctor affects health of emotionally vulnerable cancer patients

Date:
July 22, 2014
Source:
Health Behavior News Service
Summary:
The physical and mental well-being of people with cancer may be affected by how they feel about their relationship with their physician and by differences in attachment styles, finds a new study. Patients who feel anxious and uneasy with their doctor may be impacted the most. “Anxiously attached patients may experience and report more physical and emotional problems when the relationship with their physician is perceived as less trusting,” said the lead author.
It always surprises me when most people go to buy a car, they will go to many dealerships, do much internet research along with asking opinions of family and friends, test drive numerous brands and models of cars, and finally make a decision based upon what they learned and how they feel about the car they are choosing.  Frequently, they will travel to another town or state to check out other dealerships because their level of trust is not good for their local dealership or because they can get a better deal.   Often, if you ask someone who has just purchased a new car why they chose that brand, they will say, “It just felt right for me, and I liked it.”
For most people diagnosed with cancer or any serious illness, they may spend far less time choosing their doctors than they would buying a car.  Why?  These are the answers I hear most often:
  • Fear of my diagnosis and needing to just get to any doctor so the job can be done quickly
  • Insurance – maybe my insurance won’t pay somewhere else
  • Convenience – I don’t want to inconvenience my family by going to more doctor appointments.  Staying close to home is just easier

Those issues are all very, very real.  But in most cases, you do have choices.  Remember, you are hiring the doctor, you or your insurance company are paying the doctor, and they work for you! doctor-patient-team-17525513 I so admire cancer patients who change doctors mid-stream because “something just didn’t feel right.”    It takes a lot of additional courage to do that, but your life is at stake.  If you have ANY reservations about your physicians, get another opinion.  Or better yet, get two opinions. If you have a great team of doctors, I would love for you to post and tell me about them!  Or if you had to change doctors, I would also appreciate hearing about this!

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Scanxiety, Mammograms, and Cancerversaries

This week was my yearly mammogram and also my 6 month checkup with my Oncologist.   This week marks my THREE YEAR cancerversary from diagnosis of Stage 3, Her 2 Positive Breast Cancer, very large tumor with 9 positive nodes.  So often I hear from women who wonder if there is something wrong with them that they have so much anxiety before scans, mammograms and tests!  Absolutely not!  It is all NORMAL!!

As I was driving the 70 minute drive to get the mammogram this morning, I once again realized just how normal it was. .  That anxiety never gets better, but at least it is more familiar as the years go by.  Like an old acquaintance that you have a meeting with and walk away thinking, “Oh, that’s why we were never friends!”   Today when the anxiety arrived, right on schedule, I thought, “Well, here you are again.  Okay, what if it is breast cancer?  You know what to do, you know what to expect, and you know you will either get through it or die.”  And the other thoughts also arrived on time:  “Why didn’t you just get that breast cut off – no breast is worth this much anxiety, just turn around and go home, call the Breast Cancer Center and tell them you had a flat tire, and then finally as you get closer, the hell with it, I’ll just get it over with today!”

My nerves were kind of under control as I put on the oh-so-familiar teal gown (why haven’t they gotten new gowns here yet?!?) after I stripped to the waist.  I’m much more vocal now in the waiting room than the previous years.  I start asking who the survivors are, and they are eager to talk!  It is 90% of the waiting room because we are in a Cancer Center.  It makes the reality of what we are waiting for seem less frightening and there is an instant bond without too many words.

When my name was called, the nice technician talked to me and then told me her best friend was just diagnosed.  She began asking questions, and I began giving her tips to tell her friend as she plops my breast on the machine.  Silly thoughts go through my head — like after the first squeeze I remembered to lift my breast up rather than pull it off the platform because the skin sticks!  I’m applauding myself for remembering from last year!   Soon it is over, and I try to read the tech’s face.  But all I remember is the face of the technician from 3 years ago whose mouth literally dropped when she looked at those cancer-ridden pictures, and though she tried to recover in a professional manner, her face is still is embedded in my head.

Back to the waiting room…I start talking to myself and bargaining. This time without quotation marks!  Okay, I won’t worry for 10 minutes.  They usually have the results in 10 minutes.  If it is longer than 10 minutes, then I will worry.

Kelly Ripa is on the television in the waiting room doing something ridiculous, and I wonder why anyone really likes her.  Then I chastise myself because my old and dear friend, Cathy, loves her, but I think: how can she watch this TV show?  The 10 minutes are up.  OH Lord, please help me, and His peace descends upon me.  Really.  I felt it.  The door opens and a solemn-faced woman about my age calls my name.  In my head I think, gosh, I need to smile more so I don’t get like that and then she says, “I can’t tell you the results in the hallway because of HIPPA” and I’m thinking it is BAD news because last year the woman blurted it out in the hallway.  But we get to the room and her face broke into a smile and she said, “All is well” as she handed me the “ALL CLEAR” letter signed by a real doctor.   I always grab the letter and look at the signature to make sure it says “MD” after the signature! I immediately just grabbed and hugged her and hugged everyone coming down the hallway.  Then I think, Denise, you do that every year, you need a new routine, then I think, who the heck cares – I can’t help it.  Then I tell the techs gathered in the hallway that this is the worst day and the best day of the year all before 9:45 am.

When that paper is handed to you and you hear those words, it is like God is handing you a beautifully wrapped present and in it is your life for another year as you hear a choir of angels in the background.  You think of the magnitude of that gift, look at that package, and tell God, “Thank you for my life.  I don’t want to screw it up.  Tell me what you want me to do this year, and I will do it.”

And I enter back into the waiting room.  Kelly Ripa is still on the television and this time I think:  Kelly is friendly, cute and she is kind of zany.  I understand why people watch her.