Not so long ago, the doctor spoke from on high and the patient listened. Today, doctors and patients work best when they are partners, most of all when life-threatening, chronic illnesses such as breast cancer are involved. Patients often become experts in their own disease and should feel comfortable their doctor will respect what they've learned, answer their questions, and share information about breast cancer with them willingly.
Of course, that's often easier said than done. How do you build a relationship like that with your doctor? How do you approach him or her with a new breast cancer study or concerns about an existing treatment? Here are some useful tips:
Before discussing breast cancer, it's important to be familiar with the anatomy of the breast. The normal breast consists of milk-producing glands that are connected to the surface of the skin at the nipple by narrow ducts. The glands and ducts are supported by connective tissue made up of fat and fibrous material. Blood vessels, nerves, and lymphatic channels to the lymph nodes make up most of the rest of the breast tissue. This breast anatomy sits under the skin and on top of the chest muscles...
Interview your doctors at the start. It may be the last thing on your mind when you've just been diagnosed with breast cancer. But this person is going to play a very big role in your life for months and years to come. Even if they're brilliant and come highly recommended, you'll want to interview them to decide who is best for you. If you're not at ease with them, don't feel as though you can talk to them, or feel they're dismissing your concerns, consider finding a new doctor.
Bring in as much information about the new breast cancer treatment you're interested in. Saying "I saw this story about a new drug on the nightly news. Have you heard about it?" doesn't give your doctor much to go on. Potential new cancer treatments making headlines almost daily. Instead, copy or print out the newspaper or journal article you're asking about. Highlight the parts you think might apply to you. Then ask your doctor.
Write down your questions ahead of time. It's a sad fact of modern health care that your doctor has limited time to spend with you. To make the most of your visit, write down your questions about the new treatment (and leave room to take note of your doctor's answers). That way you can focus your talk and make sure you don't forget to ask something important until you're in the parking lot.
Understand your doctor's desire to be cautious. When a new drug or therapy is approved, that doesn't mean that there isn't still more to learn about it. Often, more information is discovered in the first few years after it's approved for use in large numbers of people, outside the highly controlled environment of clinical trials. For that reason, many doctors prefer to take a wait-and-see approach with new drugs, especially if a patient is doing well on an existing therapy.
Published March 2005. SOURCES: Clifford Hudis, MD, chief, Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York. Claudine Isaacs, MD, director, Clinical Breast Cancer Program, Lombardi Comprehensive Cancer Center at Georgetown University Medical Center, Washington, D.C. Aman Buzdar, MD, deputy chair, department of breast and medical oncology, University of Texas M.D. Anderson Cancer Center, Houston. Breastcancer.org.