Nurturing Hope And Compassion In Cancer Care

Doctors do more than prescribing medicine to cancer patients. Besides treating the illness, they also help with the emotional aspect. They follow special guidelines of caring for patients and some even speak up for better resources and support for people with cancer. They are like guides, helping patients through tough times and spreading hope.

Creating hope during diagnosis

When delivering tough news to cancer patients and their families, there's no one-size-fits-all approach. Dr. S Hukku, Advisor - Department of Radiation Oncology, Sir Ganga Ram Hospital, New Delhi emphasised the importance of this moment, acknowledging the anxiety and fear patients feel while awaiting their diagnosis. He suggested that some families keep the truth from the patient, but honesty is crucial especially if the patient is educated and can better understand their situation.

He stressed on the significance of explaining the treatment plan without dwelling on the potential outcomes, especially in advanced cases where the prognosis may be bleak. Instead, he advises discussing the prognosis with a responsible family member to ensure everyone is on the same page. Hukku cautioned against making definitive predictions about survival, as every case is different. “The policy is to tell the patient what we are going to do, what we have in store, but don't discuss the outcome because that will be very depressing. Discuss with the family member and not with the patient,” he added.

Dr Vishal Rao, Director- Head & Neck Surgical Oncology & Robotic Surgery, HCG Cancer Centre, Bengaluru stressed on the importance of balancing honesty with hope. He believes breaking bad news is an art that needs personalised attention, considering various factors like the patient's understanding and emotional state. Rao mentions how some families request not to inform the patient about the diagnosis, which has legal implications. He also talked about the power of hope, acknowledging its importance but cautioning that it is not a cure-all. “We are in an era of informed decision-making, where we provide patients with the necessary information. It's our responsibility to support them through this process while assessing and providing psychological and psycho-oncological support.” he added.

Doctor-patient communication

Hukku highlighted a common issue that doctors often have very short time slots to see patients, sometimes just 5 or 6 minutes. He believed patients need more time, so he gives them at least 12 to 13 minutes to talk when they come for their diagnosis. “Listening to patients is key, as they feel more comfortable when they can share their concerns. In busy hospitals, doctors may rush, but taking the time to listen helps ensure important messages are effectively communicated”, he added.

Jyotsna Govil, Chairperson of the Indian Cancer Society, raised an important point about doctor-patient communication. She noted that while patients often ask about their life expectancy, they also value the time to talk and gather information during appointments. Govil acknowledged improvements in communication over the years but emphasises the importance of doctors allocating enough time for meaningful discussions with patients. She believes that while communication skills are improving, time constraints remain a challenge.

“There are people who have survived cancer and who have gone out to help others. They have not sat at home doing nothing. This is what is most encouraging,” she added.

Education for better cancer care

Hukku stressed the importance of education in cancer care, focusing on three main areas: educating medical students in fields like Surgical Oncology, Radiation Oncology, and Medical Oncology; raising awareness among primary care physicians about cancer symptoms to prevent misdiagnosis; and educating patients to promote early detection and lifestyle changes. Despite education's crucial role, it often lacks priority due to financial concerns, leaving NGOs to bridge the gap. Hukku urged hospitals and institutions to prioritise education for better cancer outcomes.

Positive outlook

Rao shared a surprising finding from a study about the power of negative thinking, suggesting that acceptance and expectations play a significant role in a patient's outlook. He contrasts this with overly positive thinking, noting that neither positive nor negative thinking guarantees outcomes. Instead, it is about accepting reality and managing expectations, which is crucial in counselling patients.

Govil emphasised on the holistic fight against the disease and its impact on the patient's life. She stressed the importance of becoming not just a survivor, but a successful and joyful one, recounting a patient's gratitude for restoring respect within her family. The aim is to transform patients into vibrant individuals ready to embrace life.