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Partnering With Your
Health Care Team
The doctor-patient
relationship, like any other relationship, depends upon open
communication. Expecting complete information from your health care
team also requires that you provide them with complete information.
This chapter has been written with the breast cancer patient in
mind. Feel free to make copies of this material for your patient (or
give the Breast Care Coordinator a call if you would like us to send
a copy to her).
Information the Health Care Team
Needs to Know about a Patient to Develop the Appropriate Treatment
Plan*
1. Close relatives
who have had cancer and the type of cancer that they have had.
2. Your goals
regarding your quality of life during and after treatment and your
optimism or pessimism concerning recovery.
3. The degree to
which your life style or personal circumstances will affect your
treatment choices.
4. Whether you want
to have children in the future.
5. How much you want
your health care team to share information concerning your
treatment, test results and prognosis with others and who those
people are.
6. How much or how
little you want to be involved in decisions concerning your
treatment options and test results.
7. If you have a
durable power of attorney for health care and/or advance directives
in case you become too sick to make informed decisions and who
should make decisions for you.
8. If you want a
second opinion.
9. Other therapies
you may be using in conjunction with standard treatment and all
prescriptions and over-the-counter remedies that you are taking so
that you can minimize the chance of one medicine counteracting
another.
10. Any symptom(s)
that may indicate side effects of a medication(s) you are taking so
that they can change the dose or medication and/or treat the
symptom(s).
*Source and Suggested Resource:
Adapted from: Imagery for Healing and Wholeness © 1995, Arlene
Harder, MA, MFCC P. O. Box 6708, Altadena, CA 91003-6708,
818-797-3834, Fax 818-798-5815
How to Communicate Effectively
with the Health Care Team
As you know, when
patients are first told that they have breast cancer they are
overwhelmed with the shock of the diagnosis and with the decisions
that need to be made. Under these circumstances it can be difficult
to hear, let alone understand, absorb and remember what a doctor is
telling them.
Following are a
number of suggestions that you can give to your patient. These
suggestions will increase her understanding and recollection of what
has been said. They will also alert her to the kinds of information
that her doctor and the other members of her health care team will
need from her. It is important to remind patients that no question
is stupid or a waste of time.
Suggestions to Help Patients Keep
Up Their End of the Communication*
1. Before each office
visit, write down any concerns or questions you want to discuss with
your doctor and bring the list with you to the visit.
2. Do not wait until
the last minute to ask important questions; let your doctor know at
the beginning of your visit that you have them.
3. Bring a friend or
family member with you on medical visits; they can help you ask
important questions and recall the answers.
4. Bring a tape
recorder (with your doctorís permission) with you to your medical
visits so that you can review information as needed at a later time.
5. Let the office
know in advance if you need to talk with your doctor for an extended
period of time.
6. Describe any
discomfort or pain as accurately as possible. Do not accept pain as
something unavoidable that you must endure.
7. Report any changes
that concern you regarding your physical or emotional health.
8. Ask your doctor to
repeat instructions or information that you do not remember or do
not understand.
9. Ask for written
and video patient education resources.
*Source and Suggested
Resource: Adapted from: Imagery for Healing and Wholeness © 1995,
Arlene Harder, MA, MFCC P. O. Box 6708, Altadena, CA 91003-6708,
818-797-3834, Fax 818-798-5815
Ten Priority Questions for
Physicians that will Help Patients Understand Their Breast Cancer
Diagnosis and Breast Cancer Treatment Options
1. What does my
diagnosis mean?
2. Can I have a copy
of my pathology report?
3. How advanced is
this (tumor)? / What type and stage of breast cancer do I have?
4. What are my
treatment options?
5. What do you expect
the treatment to do?
6. What are the
short-term and long-term side effects and risks of the suggested
treatment?
7. What might happen
if I decide not to have this treatment?
8. How long will I be
in treatment?
9. How long will this
treatment take each time and what does it involve?
10. Are there
alternative treatments? (Clinical trials, complementary treatments
and other options.)
Listen to Understand
- Be sure to get clarification if you do not understand the answers
to your questions. If you feel any answer is not complete, ask more
questions. This is where alternating open-end and close-end
questions might be a technique that will assist you (see
"Communication Skills for Breast Buddy Volunteers" page
84).
General Questions to Help Patients
Learn More about Follow-up Care and Breast Cancer "Risk
Management"
1. After I have
completed my treatment, who will be in charge of my medical care and
how often will I be seen for follow-up visits?
2. Will I be
monitored to see how I am doing? What other kinds of tests will I
have and how often?
3. Are there
"do's" and "don'ts" that I should follow after
treatment and for how long?
4. Are any of my
relatives at an increased risk for breast cancer? If so, what is the
risk?
5. What are your
recommendations for breast cancer screening (breast examinations by
a health care professional, mammograms) and how often should I be
screened?
6. How often and at
what time of the month should breast self-exams be done? Can you
teach me how to do a proper breast self-examination (including
reconstructed breast(s)/mastectomy scar examination?
7. At what age should
breast examinations begin? Do you have instructional materials on
breast self-exams and healthy lifestyles (nutrition, etc.) that I
can use and give to my relatives and friends?
Summary of General Questions to
Ask Your Health Care Team about Breast Cancer Treatment
Answers to the
following questions will help your patient get through her
treatment(s) as smoothly as possible and on to her recovery and
follow-up care.
1. Please explain
what this treatment is and what it will do.
2. What are the
short-term and long-term benefits of this treatment?
3. What are the
short-term and long-term risks of this treatment?
4. What are the side
effects of this treatment? Is there anything that I can do to
prevent or reduce any side effects?
5. How will this
treatment affect me emotionally and/or sexually?
6. Can you refer me
to a counselor, a support group or another person who has been
through this to help me deal with some of the issues with which I am
struggling (such as emotions, sexuality, relationships)?
7. How might this
treatment affect my lifestyle and my ability to continue working and
doing other activities (work, exercise, diet, etc.)?
8. Will this
treatment affect my ability to have children?
9. Is it possible to
get pregnant while I am in treatment? If so, what should I be doing
about birth control?
10. Are there any
precautions ("do's" and "don'ts") that I should
know about before I begin my treatment? (such as shaving underarm(s),
cosmetics, exposure in the sun, etc.) How about during treatment?
11. Are there
"do's" and "don'ts" that I should follow after
treatment and for how long?
12. Are there any
nutritional and other complementary practices/therapies that I
should follow to help reduce any side effects and to keep me healthy
and strong while I am in treatment?
13. How can I find
out more about this treatment?
Problem-solving Tips for
Volunteers and Patients
There are many
problems that can surface following a breast cancer diagnosis.
Everyday stresses are compounded by the need for patients to
rearrange their lives to accommodate doctor appointments and make
treatment decisions. The following problem-solving tips have been
designed to help break problems down into manageable steps.
Problem-solving
Techniques | Problem-solving
Worksheet Last Updated: 02/12/2003
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