Deer in the Headlights
Last week I had the unpleasant task of informing a lady in her 30s she has breast cancer.
Sometimes we know before the biopsy a breast lump is cancer. Sometimes we’re pretty sure a lump is benign. This lump was a 50:50. It felt like a fibroadenoma (non-cancerous breast change, common in young women), and was reported as likely that by the radiologist - but I didn’t like the look of it.
I couldn’t really prepare my patient and her husband one way or the other. I didn’t want to stress them too much, but needed them to be aware of the possibilities. Then again, perhaps no preparation can really dampen the shock of a cancer diagnosis. We know it’s an ever-present possibility for all of us. But, hey…come on…not ME?!!!
My patient and her husband took the news as well as could be expected. But really, they looked like two deer in the headlights. Frozen. Trying to process what was going on.
I started to talk. Counselling a patient with cancer is always complex. Add in youth and the conversation goes to another level. In addition to all the usual aspects of a breast cancer diagnosis, we may need to discuss fertility, genetic implications, a potential for premature menopause and more.
It’s hard enough as a cancer specialist, to be across all of this and to manage it well. And I’ve trained for years and layered years more experience on top. For a patient – an accountant, or mother, or dental nurse, or student – it’s almost impossible to comprehend. And the pressure is on. Not only are you a deer in the headlights…you’re trying to speak a different language at short notice.
Debilitating anxiety and a feeling of information overload is normal. Fortunately, there’s help available. There always is when we encounter a problem we don’t have the skills to deal with on our own.
A good breast cancer team will surround you with the information you need and break it down to manageable pieces. We’ll show you the stairs but focus on just the next step for now. We’ll give you time to ask questions. And if you’re not sure, ask more questions. Maybe even the same questions again.
It’s a cliché but if you take one step at a time, there’s a good chance you’ll get to where you need to be.