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 Cancer

June 2011
Hope with Cancer
Dr. Janos Stumpf
 
It is not an easy task to support a patient diagnosed with cancer. Perhaps the myth that cancer is always a deadly disease has to be replaced by facts, to start with – after all, most of the tumours are controllable, many are curable by now.

There is a myth that treatment for cancer is always taxing – physically, mentally and monetarily to an extreme level and no one can help. First part of the sentence is true to a great extent; treatment of cancer is complex and frequently demanding too. But it is not true that ‘no one can help’. Mentally every one can help. Monetary aspect needs coordinated efforts.

Hope
There is, however, a very important message of hope – complex treatment brings better, lasting and not infrequently final, curative results. New, (though long lasting and complex) treatment can turn this ‘deadly disease’ into a ‘chronic disease’ in many cases.

Cost too is a serious factor. Yes, it is true that many of the methods bringing relief to the patient are expensive. But this is true not only for cancer. We have to accept that there is a manifold increase in the cost of healthcare today, against 20-30 years ago, irrespective of what the disease is.

Reassurance
Cancer patients always want to be reassured. This is completely understandable. Loving family members and friends must be the encouraging lot. Patients look for solutions, accurate information on the disease. And we are aware of our dependence on the Internet. The capacity of the ‘net; to give abundant information on any topic is unquestionable. However, one must never forget that there is no filtering of data. The kind of results a search engine yields is a gamble. It can be gold, or it can be dust. Who will be the judge? It is so attractive to run to the patient with the good news: ‘I have found something for you on the NET’. But never take anything for granted until you consult an appropriate or treating oncologist.

It holds good for others too. It’s best to ask someone in the know. If there is good rapport between the patient, the treating doctor and the supporting attendees, everything becomes much easier. Questions can be put directly across the table and answered sincerely.
 
Faith
Straightforward briefing is one of the most difficult jobs. It’s challenging to judge the capacity of the patient, attendees and understand to what extent they can cope with diagnosis, treatment and prognosis. It is extraordinarily important that the patient and the doctor work together. A patient must be given enough time to clarify doubts especially during the first consultation. This will help them cope with difficulties; prepare their mind to shape everything in a reasonably positive way.

Second Opinion
What about second opinion? This is dogged by controversies. While some feel it helps, others say it only adds to the confusion. It depends. If consultation with a reputed doctor clarifies everything, there is hardly any reason to go and ‘fish for opinion’. One has to understand that every doctor advises based on his personal experience. Medicine is not a science, and patient is not a machine. An experienced doctor is well reputed because he can apply his vast experience to help the patient efficiently. Their advices can differ. However, mostly the difference is minor only. But for a layperson it looks substantial. How would a patient know that the two different medicines prescribed by different consultants do the same job? Sometimes they are even identical, but sold under different names.

Right Oncologist
Care of oncology patients comes with its challenges. The primary doctor is hardly ever an oncologist. A surgeon is making the diagnosis usually by biopsy. It is the duty of the primary doctor to involve an appropriate oncologist. Selection of the right oncologist (Surgical, Medical or Radiation Oncologist) is important and not simple. Care for the patient requires different skills all through the treating and monitoring procedures. It is very difficult to have a general rule; every case is different. But those hospitals specialized for cancer treatments do have a panel of appropriate specialists and a well-established routine to provide service to the patients. Most importantly, it’s not just enough to have faith in the doctor, but the institution too must be trusted.

Right Advice
There is a vast difference between groups of supportive people in India Vs. the developed (industrial) countries. In India, it is less specific, less professional and more empathetic. The Western support is usually more professional with less empathy. Everybody wants to help, but few only know how. Everyone wants to give advice, but only few know what to advise. It is easy to advise patients asking them not to smoke or drink, regularly consume juices and coconut water and avoid non-vegetarian foods, etc. As a matter of fact, it is not right to follow these advices, at least not without proper check.  In principle, the lifestyle of the patient before diagnosis has to be respected, for substantial change in the diet hardly does any good to the patient.
Every patient requires moral and spiritual support. Religion, yoga, open discussion or sometimes, the simple presence of a beloved one, or meditation can help. Adopt the right approach while dealing with cancer patients.

Years ago, one of my patients was diagnosed with a very bad disease. He was extraordinarily intelligent and knew everything about the prognosis. He was shattered about his cruel future, considering he had recently married. I had no hope to give him either. My advice was simple: “Whatever God or faith has foreseen for you is not challengeable. It can last long, but unfortunately time for you can be very short too. Please fill every single day with love as if it was the last day of life!” He got the message right. The couple was coming for the treatment hand in hand smiling at each other, thereafter. I wonder why we ordinary people are not doing the same, even without having to deal with the pressure of battling a deadly disease!

The bottom line is, when you know someone’s going through a rough phase, the least you can do is find ways to bring joy into their lives by offering hope. Be aware that the patient is likely to experience a variety of emotions and mood swings, and so, be tolerant to their behavior, which definitely gives them the much-needed moral strength. 

Dr.Janos Stumpf is Advisor Oncology & Cyberknife Services Apollo Speciality Hospital Chennai


    
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