Diagnosing Kidney Cancer
I try to see the patient in person to give him or her bad news, such as a new cancer diagnosis. I usually take the patient through what tests we’ve done and what we found. Then, after giving the diagnosis, I explain how we’re going to manage it and who will help us. It’s important to present a well-defined plan of action. I make sure to let this all sink in and then ask if there are questions. I then talk about the nonmedical pieces: the information seeking, writing, and both medical and nonmedical support communities as above. Finally, because I know most of this won’t make sense until later, I offer the patient follow-up conversations.
Some patients do better than others coping with a diagnosis, depending on the strength of their character and their existing social supports.
The Causes of Kidney Cancer
I am not a specialist, so I am not qualified to address this. But kidney cancer has no identified causes of which I am aware. It’s important for patients not to blame themselves for any diagnosis. That may make it harder for them to be actively engaged in fighting it.
Kidney Cancer Care Teams
As the primary care physician, I am a part of the patient’s team, as are his or her friends and family, patient support community, and the rest of the patient’s health care team. The latter includes:
- Radiation therapist
- Oncology nurses
- Social workers
Others depending on the situation, possibly including a palliative care team
Treating Kidney Cancer
For any patient diagnosed with cancer, I encourage him or her to reach out to the members of the care team, to maintain good spirits, to exercise, and to eat well and more than usual, so as to maintain weight and strength.
Tools and resources:
- CaringBridge and other websites for patients
- Information, including the National Cancer Institute’s PDQ database
- ACOR.org or other online support communities
- ClinicalTrials.gov and other sites that list ingoing clinical trials
- MLANet’s website that tells patients how to evaluate health websites
We use PatientSite, our patient portal, to allow patients to see their records, make appointments, and communicate with us online.
One of my patients did what Normal Cousins recommended in Anatomy of an Illness: he felt it would be good to keep up his spirits and possibly boost his body’s ability to fight disease, so he obtained all the Bugs Bunny cartoons he could find and watched them.
In general, I recommend patients continue activities that make them happy and keep them occupied: hobbies, relationships, or anything that brings them pleasure and satisfaction.
Beyond Kidney Cancer
It’s a privilege working with patients through health and illness. Helping patients through these difficult times is what it means to be a physician, and as a result the patient and I (and the patient’s family) grow closer.
I wish that all patients, not just cancer patients, would be engaged in their health care and that all physicians would encourage this engagement. Technology will help lower barriers to patient engagement, but the attitudes of providers and patients must change as well. This requires cultural change and a great deal of education: physicians educating physicians, patients educating patients, and patients and physicians educating each other.