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Let’s Talk About It: Overcoming the Cancer Fear Factor

June 21, 2019

If you’ve heard it once, you’ve heard it many times: Communication is key – in our jobs, our personal relationships, and the ways in which we exchange information with the world around us. So, why does talking about cancer feel so scary?

Dr. Lalan Wilfong, Texas Oncology’s executive vice president of quality programs and medical oncologist at Texas Oncology–Presbyterian Cancer Center Dallas, discusses the important role of communication in care, recovery, and overcoming the cancer fear factor.

What are common fears among cancer patients?

Most patients experience fear upon receiving a cancer diagnosis, and some even discover fears they never knew they had. Common fears patients face include fear of the unknown, fear of a specific type of treatment, such as chemotherapy, or side effects, and fear of death. For others, there is a fear of being a burden, losing control of their health, or fear of feeling pain. All these fears are completely natural and understandable. 

Dr. Lalan Wilfong, vice president of value based care and  quality programs at Texas Oncology and medical oncologist at Texas Oncology–Presbyterian Cancer Center Dallas

How can two-way communication between patients and their care team alleviate fears and improve the patient experience?

We’re the experts on cancer and treatment, but we’re not the experts on the patient as a person. They are the only ones who can say what’s going on with them physically and emotionally, and we rely on them to talk to us about what they’re afraid of when it comes to their cancer and their care. Unless we know what a patient values or is currently experiencing, we can’t help to the best of our ability.

How do you help patients look past the medical jargon and ensure they understand their diagnosis and treatment plan?

I ask patients to put their fears aside and ask questions if they don’t understand something. We should all feel empowered to ask questions about our health. Once I had a breast cancer patient who was afraid her hair was going to fall out, but she didn’t tell me that. A few months into her treatment she came to me and said that she didn’t think her treatments were effective because her hair was still there. Her treatment didn’t cause hair loss, but I didn’t know she was afraid of that so I never addressed it with her. She kept her concerns to herself and lived quietly in fear for months wondering if her treatment was working, simply because she didn’t voice her concerns over losing her hair.

Can communication directly impact a patient’s outcome?

In short, yes. I tell my patients that If I don’t know they’re nauseated or in pain, I can’t help them feel better. If a doctor doesn’t know how a patient is feeling, they might make decisions that ultimately cause more harm than good. For example, if a patient doesn’t express that they’re not feeling well, the doctor can’t make adjustments to their medication. If we don’t treat the side effects, they can worsen, leading to hospitalization or stopping treatment altogether. If we can intervene early, when side effects first appear, we can make impactful changes to improve outcomes.  

What advice do you have for newly diagnosed cancer patients?

There is nothing you can say to your doctor that will surprise them.

Patients should be active participants in their treatment planning process. Come with questions, and bring someone with you because you won’t remember everything. Take notes, ask for clarification when you don’t understand something, and tell your doctor your fears.”

If you’re uncomfortable talking to your doctor, there are many others you can talk to, including nurses, advanced practice providers (APPs), and other members of your cancer care team. By talking about your fears with those around you, you can truly enhance your cancer journey – and that peace of mind is invaluable.

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