The diagnosis of cancer usually comes as such a shock to the patient that during the first visit to the doctor's office, he is not able to receive much information about his treatment. On the other hand, doctors often do not have enough time to explain everything to the patient during subsequent visits. How to deal with this situation is suggested by Dr. Alicja Heyda, a psychotherapist and psycho-oncologist at the IMSC Cancer Center in Gliwice.
Cancer patients in Poland declare, on the one hand, that they want to be partners of their doctors - to know and understand all treatment options they can choose from, on the other hand, most of them admit that they rely on their doctor's decisions during treatment . These are the conclusions of many studies, including a new survey conducted by the Federation of "Amazon" Associations, as part of the ongoing campaign "As Is - I Have a Choice!", Addressed to patients with advanced breast cancer.
- Polish patients, although they have a much lower need for information than, for example, patients in Anglo-Saxon countries, want to be treated as partners, understand all the options they are to have and have an active part in making decisions about treatment. It is worth taking this into account in the process of diagnosis and treatment - says Alicja Heyda, psycho-oncologist at the IMSC Oncology Center in Gliwice.
He adds that there are of course types of cancer where the patient does not have too many options. In some oncological treatment regimens, however, there is a choice.
- It is known that the patient is not a specialist and to some extent must trust the doctor. However, the doctor's approach is very important. How he communicates information to the patient. The partnership approach certainly supports the patient very much - says Krystyna Wechmann, president of the Federation of "Amazons" Associations.
Shock stage
According to Alicja Heyda, she adds that providing information about treatment and talking about possible options should be circular. The point is for staff to ensure that the patient and his family are fully informed and aware.
- When I talk to patients, they very often declare that during the first meetings with the oncologist, they did accept his decision regarding treatment, but they remember little about the visit, says a psycho-oncologist from Gliwice. - There is nothing strange about this. In the face ofof diagnosed oncological disease, practically everyone undergoes a shock stage at the beginning, during which they are not able to accept the information about the disease and its treatment provided by the staff. Suddenly, the whole order of life is in question. How to remember what a doctor says when fundamental questions are pulsating in your head: what will happen to me? What about my family, work? - he adds.
The phase of such a first shock may last from a few to several weeks. After this time, most patients adapt and acknowledge that they need treatment. Only then do the questions start to arise: about the side effects, in the case of breast cancer, about the issues related to hormone treatment, about whether it will be necessary to go to the hospital.
- Patients often face many myths about chemotherapy at this stage. To this day, for example, you can come across "magic" thinking about radiotherapy. They ask doctors whether during this therapy they can have contact with other people, hug their relatives, grandchildren, or play sports. Although it has long been known that these issues are not a problem - says Dr. Heyda.
Lonely people have a harder time
All studies, including the largest ones, conducted on thousands of patients, unequivocally confirm that contact with close people is of great importance for the success of therapy. Patients who have a lot of social interactions - with family, friends, and other patients, receive therapy much better.
- Without bond, intimacy, and the love of other people, it is very difficult to heal oncology and live later. That is why doctors always ask patients questions such as: "do you live alone", "what are your contacts with people like?" It is certainly much harder for lonely people. That is why the activity of support groups or organizations such as Amazons cannot be overestimated! - underlines Alicja Heyda.
Patients should know that the help of psychotherapists in oncology clinics is also at their disposal. In Poland, there is still an erroneous association between a psychotherapist and a psychiatrist, to which we go only when we have serious problems.
- Everything that helps you distance yourself from your situation and receive information and support is advisable - emphasizes the psycho-oncologist. - Fortunately, thinking about the patient as a "carte blanche" has long since stopped. Each sick person is a unique individual, with his own baggage of experiences, memories, and his illness and therapy must be viewed with all these relationships in mind.
Don't be afraid to ask!
According to experts, providing information about treatment and talking about possible optionsshould be circular, so that the staff can be sure that the patient and family are fully informed and aware. Unfortunately, there is one more important issue in the patient-doctor relationship in Poland. It is the time pressure during visits. A team that conducts a council of several dozen patients during the day must make the most responsible decisions.
- So we have a situation in which a stressed patient usually meets a busy doctor. This is a very unfavorable combination - says Krystyna Wechmann. He adds that also for this reason the Amazons want to lobby in the near future for Polish oncologists to be able to have additional staff support during visits. The nurse would relieve the doctor of the "paperwork", so that he could focus only on contact with the patient.
Both the president of Amazonki and the psycho-oncologist in Gliwice advise that a patient who goes to see a doctor should prepare the questions he wants to ask calmly at home.
- Patients show up regularly for follow-up visits. This is the time when they should be asking questions. They should also remember that doctors also do not want to overwhelm patients with loads of information and usually adapt their answers to what is asked of them. If we feel that the doctor has not told us about an aspect that is important to us, let's ask! - says Alicja Heyda.
He adds that not all information is required from the doctor. Some of the practical advice can also be provided by experienced nurses or physiotherapists who take part in the therapy.
Although in recent years the awareness of psycho-oncology in Poland has advanced very much - the real siege is being experienced, among others, by workshops for patients - not all patients are still actively looking for information. There is also a large group of patients who rather want to get away from what is happening.
- This is one of the typical defense mechanisms of the psyche. Instead of facing the problem, we run away from it. In Poland, we have a clear psychological tendency to be extremely independent. In extreme cases, such an attitude may take the form of completely refusing to receive outside help - says the psycho-oncologist.
Also in such a situation, the presence of family, relatives and professional psychological help will be invaluable.
Worth knowingLong Term Campaign
It's As It Is - I Have A Choice! is a long-term campaign aimed at women struggling with advanced breast cancer. During its duration, the Amazons will talk about the problems of treating cancer in a medical, psychological and social context. There are two in the title of the campaignimportant aspects for patients: its first part is to emphasize the importance of realizing that advanced cancer is not the end of our life, but its stage, so it is worth tame it and learn to talk about it; the second is to make patients aware that, together with their doctor, they have an influence on the choice of therapy and the course of treatment.
As part of the campaign events, there will also be workshops and educational meetings all over Poland, films about the history and future of the Federation will be made with the participation of, among others: Krystyna Wechmann, President of the Federation of "Amazon" Associations, actress Hanna Śleszyńska and writer Krystyna Kofty. Amazons will also prepare a publication about breast cancer and a guide dedicated to patients and their relatives, It's as it is, about the importance of an open conversation in cancer.