/6/08
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Today was a day that I was actually slow in the office. Most days are days that I run behind & struggle to keep up. Today was one of those rare days that my list was light & I felt like I had plenty of time to spend with my patients, return phone calls to referring physicians, do some research on different treatment protocols & to actually do some journal reading, it was a really nice day.
I have a patient that has Non-Hodgkin’s lymphoma. The patient’s treatment course has not gone well, it has been interrupted by hospitalizations from toxicity from chemotherapy, and she has had treatment delays because of low blood counts. The treatment has been delayed because of evaluations at tertiary care facilities for possibility of a stem cell transplant. All these things have conspired to make her course a very rocky one. This patient has been a patient that has handled these ups & downs extremely well, however, today’s discussion turned to the possible need for radiation therapy. I’m constantly amazed at the fear that a lot of patient’s have about radiation therapy. This fear, although sometimes very justifiable, seems out of proportion to patient’s fear & concern to chemotherapy. As a medical oncologist, I feel deeply that we have to look at all tools at our disposal as gifts from God to be used absolutely in the best possible way to benefit our patients. This would include chemotherapy, radiation therapy, complementary medicine, even at times alternative medicine. I’ve learned early in my career that the mind and faith of a patient plays a bigger role in whether that patient gets well & how they will do than all the other factors that go into how the patient tolerates the therapy. A patient who truly fears any kind of therapy will ultimately do worse than a patient who is able to overcome their anxiety about the treatment. Patient’s should know that some degree of anxiety & fear associated with treatments that they have to go through as a cancer patient are justifiable & real. I think as an oncology community we do a poor job at adjusting the idea of fear in our patients. The idea of fear in our cancer patient’s, have fear in cancer itself, fear of the treatments that we are recommending to them, fear in altered body image, and the list goes on and on.
I spent a lot of time with my patient with lymphoma trying to relieve the fear of radiation therapy; ultimately I don’t think I was successful.
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