Why Don’t Cancer Doctors Prescribe Hope?

Why Not Prescribe Hope?

When you ask a doctor, “What are my chances?” or “How long do I have?” their responses usually fall on the side of caution – not hope.

They might quote statistics about people like you who have your condition. Then they might hedge by saying people with previous conditions like smoking, diabetes, heart conditions, could do worse; or people who eat well, exercise frequently, and have a good family history could do better.

So you leave the meeting confused.

Instead.

Why couldn’t they be more positive?

• Could they discuss how the survival rate has increased over the years as new medications, treatments, and therapies have been developed?
• Could they mention that it takes 15 years of clinical trials, in some cases, to confirm theories of new treatments that are more effective than the standard protocol? That means some courageous doctors are more likely to prescribe new treatments while other doctors will stick to the standard plan.
• Could they suggest mind-body exercises, like yoga, exercise, meditation, that could put you in a positive frame of mind?

You might leave the meeting feeling positive and hopeful instead of worried and dejected.

Would that be so bad?

So why don’t doctors offer a glimmer of hope?

That’s a rhetorical question. I don’t know why medical staffs are trained to be non-committal.

Perhaps they are afraid of being sued if they are too optimistic and you don’t pull through.

Perhaps they are afraid of offering “false hope?”

But why is the alternative “false despair?”

Studies show that patients with a positive outlook on life have better outcomes than people who don’t.

Would you rather leave the doctor’s office with a sense of hope or a sense of uncertainty and despair?

There has to be a better way to break the news. Here’s a dialog I think might help.

 

Reframing Breaking The News of a Cancer Diagnosis

I’ll never forget how my doctor first told me about my diagnosis:

“You were dealt a bad hand,” she said. “You have Multiple Myeloma, a blood cancer. And you have the most aggressive form.”

When I told my primary doctor about this, he said, “She really said that? That’s cold.”

How did your doctor break the news to you?

How did you feel about that?

When she said, “You have cancer, and there is no cure,” I immediately thought I was going to die. I didn’t hear anything else she said because I was thinking: “How long do I have? Can I beat the odds?” I didn’t hear her say, “But we can treat this.”

One doctor told me that patients forget about 80 percent of the information from the first meetings. Patients are flooded with emotion and overwhelmed by the avalanche of material.

Certainly, there must be a better way.

How does this sound?

DOCTOR: We reviewed your tests and noticed some abnormalities.

PATIENT: Oh no. That doesn’t sound good.

D: We can probably get this under control with medications over the next few months.

P: Phew. You scared me at first.

D: You might experience some discomfort. Possibly fever. Vomiting. Insomnia. But you won’t lose your hair.

P: Well, that’s good news. I love my hair.

D: I  want you to know that you didn’t do anything to get this diagnosis. And you couldn’t have done anything to prevent this. There is no cure. But it is treatable. How does this sound so far?”

P: Okay, I guess.

D: Good. We’ll take good care of you.

P: Thank you.

D: In case you’re wondering, the disease you have is in the category of disorders called cancer.

P: CANCER! I HAVE CANCER! I’M GOING TO DIE!

D: No. Remember, I said we can probably get this under control.

P: Oh yeah. That’s right.

If my doctor had framed the conversation this way, I might have left her office with hope rather than fear.

When I told my wife about the initial conversation at the local treatment center, she insisted I switch doctors and treatment centers.

My new doctors at the Mayo Clinic (you might have heard of them) were much more compassionate.

Doctors need to review how they break the news to patients so they can feel hopeful and empowered.

Your Turn

How did you feel when your doctor broke the news to you?

Did you pay attention to what they said after that? Or did you start thinking of questions in your mind?

What would you have wanted the doctor to have said?

Keep this as upper case for emphasis.