For our patients, ‘oncology’ translates into the word ‘cancer,’ one of the scariest words they know. Their fear certainly isn’t unfounded. Almost all of them have a story of a friend or relative who died from a neoplasm, and they have a deep fear that they could be the next victim. They very well could be. Though medicine has made great strides in preventing and treating many malignancies, cancer is still the second most common cause of death in the U.S.
I empathize. I still remember that gut wrenching moment 10 years ago when my wife and I sat down with her doctor and he spoke that fear-inducing word. Cancer. Her breast biopsy had shown anaplastic cells. As a physician who walked down the cancer road with many patients over the years, I knew the path we were about to walk together – surgery, chemotherapy, radiation…and praying for a cure.
In that moment, knowing in advance the journey we would be taking made it harder on me than my wife in some ways. I knew all that could go wrong. I knew the side effects. I knew the statistics. I knew the suffering that was ahead.
Today, my wife is likely cured, thank God. But I want to focus on how we can better help patients who, as Psalm 23 so eloquently says, “walk through the valley of the shadow of death.”
- Explain Well – It’s understandable that you are in a hurry to complete this consult as you have many other patients to see. However, it’s important to remember that the person in front of you just had their brain shut down when you shared your findings. Encourage them to bring someone else with them if you are going to give a cancer diagnosis. Give them permission to take notes. Take enough time to put everything in everyday language for them. Schedule a follow-up visit in a few days and tell them to write down the questions they have and bring them to the appointment.
- Listen Well – Ask open-ended questions like, “What are you concerns?” “What do you fear the most as we begin to deal with this?” “How can I better help you as we move forward?” Then sit back, listen, and give the patient time to relate. Ask clarifying questions when they have finished.
Use your two most powerful words whenever appropriate, “I understand.” That is what patients are looking for in their healthcare professional - someone who understands their disease, their hopes, and their fears.
- Show Compassion – Compassion is not feeling sorry for someone’s plight; instead, compassion is coming alongside your patients and helping carry their burdens. Assure patients with serious neoplasms that you will be there for them no matter what happens and that you will put together a team of experts to help them deal with their disease. Let them know that you will do your best to relieve their discomfort and the side effects of any treatments they decide to utilize.
Seek opportunities to use appropriate touch to express concern. Your hand on someone’s shoulder, the tone of your voice, meaningful eye contact, and a smile go a long way in helping your patients know you care deeply about them. Talk beyond their disease by asking questions about their family and friends and how they are dealing with this stress. When possible, teach the patient’s family how to cope and support their loved one.
- Mobilize Spiritual Coping Mechanisms - Don’t forget to get a spiritual history to find out what spiritual resources can be brought to bear to help the patient deal with this diagnosis. More than 70 percent of the population sees their spiritual commitment as an important factor in making sense of their disease and their ability to handle their treatment journey. This history doesn’t take long and a number of descriptions are available in the literature on how to accomplish it. One of my favorites uses the acronym “GOD.”
o G = Is God, spirituality, religion, or faith important to you?
o O = How often do you meet with others? How do you integrate with your faith community?
o D = What can I do to assist you in incorporating your faith into your
Your help might mean encouraging them to visit their pastor, priest, rabbi, or other spiritual advisor. Encourage them to pray and have others pray for them. Find a church, synagogue, or other support groups for people dealing with cancer that your patient could join.
- Suggest Good Resources – Don’t only prescribe medicine, but also prescribe quality resources providing the medical information they need to understand their disease. Don’t neglect the non-medical side of things. One of my favorite resources on coping with a serious disease is When the Doctor Has Bad News, written by Dr. Al Weir, an oncologist from Memphis, Tenn. It is available on Amazon for $11. This small book is full of stories, practical advice, and wonderful insights.
Taking care of cancer patients requires more than just correctly applying good science. Patients are just as concerned that you care enough to address their emotional, spiritual, and other needs.
David Stevens, MD, MA (Ethics), is CEO of the Christian Medical & Dental Associations. For more information, please visit their Web site at