Lossophy Guide: The Day You Had a Cancer Diagnosis
There was something wrong with you physically. Reluctantly, you went to the doctor. They requested you to go to a series of tests because some abnormalities had been detected. When it was time for the doctor to provide a summary of their investigation, you received the unfortunate news that there was a cancer diagnosis.
Being told that you are diagnosed with cancer can be hard to swallow. Trying to manage the shock and impact of this bad news through temporal denial or disbelief are common. It is important to realise that people often do not jump straight into acceptance right away. And that should not be the first game plan either.
Running in their head are series of convulsing doubts:
“Perhaps we need a second opinion.”
“I don’t have a family history of cancer.”
“I don’t smoke. I exercise, eat right, live right and pray right”
“I am a good person. I did all the right things. I pray every day”
Sometimes, the impact is even more distressing for people around us. I remembered receiving a client’s call, who became extremely overwhelmed by his wife’s cancer diagnosis. All my social workers were out of town, so I had to step in for this case. He broke down on the phone several times and shared that he found it hard to manage his daily routines ever since he knew about her diagnosis.
In the process of trying to comfort him, I found out that his wife was diagnosed with Stage 1 Breast Cancer. For someone dealing with a wide-spectrum of cancer work, my mind was like ‘Ah! She got the best odds among the worst outcome. The chance of survival is very high!’ But expressing that bluntly would result in a faux pas that would have killed our therapeutic connection instantly.
Years of training kicked in: the ability to suspend judgement and to listen actively.
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Slowly, a central theme emerged. He feared the possibility of losing his wife, no matter how minute the chances were. Cancer diagnosis, even those with the best odds, are nothing but rude reminders about our limited mortality. To the unenlightened, such concepts should not even make it to the surface of our consciousness.
Though we know that we will all die someday, we often hold the irrational belief that it will always come later than sooner. Being sooner always happen to somebody else. The ‘somebody else’ will never be me. An untimely death is always seen to be unfortunate and ‘rare’
Also, being good is not a prerequisite for death outcome. Sometimes, Good People Dies and Bad People Lives On.
However, should there be a day when the ‘somebody else’ becomes you, then this Lossophy Cancer Guide: The Day You Are Told You Had a Cancer Diagnosis – is for you.
Moments before D-Day
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You suspected something was wrong. You may have past moments where you had trouble sleeping, focusing or keeping a positive frame of mind. Somehow, even the strongest of mind had that pockets of fear – the fear of uncertainty. Realising that the flickering candle of your life was possibly becoming unsteady, heightening your anxiety of approaching that appointment.
But our mind do not stay in one place all the time. Mysteriously, your body may react courageously to those fears. You pushed them back. You painfully avoided crossing mental path consciously. Sometimes, you find yourself encouraging yourself not to worry over something you have no control over.
Depending on who you are with and what you are doing, your state of mind may swing like monkeys from one end to the other unpredictably. You learn to keep your mind distracted to prevent unnecessary worrying.
If that somehow describes most or part of your experience, congrats! You are a human and you are behaving perfectly normal.
D-Day – Moments before disclosure of Cancer Diagnosis
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Feeling intensify, but you try to keep a cool front. More nervous perhaps, but nothing too overwhelming. If someone was there to accompany you to the hospital, awesome. If not, then you probably had your reason for not doing so. Though conversation do keep the worrying at bay, but that does not completely take away the occasional drift back to your reality: the experience of travelling to the hospital, the checking-in of appointment, the sitting at the waiting area, the glance on other patient’s face, the cold temperature of the room, the buzzing of the queue numbers or the work-preoccupied look of the hospital staff.
At this moment, you are unsure on how to make sense of your state of mind or emotions.
You just have to wait.
Then the dreaded number flashed by. You knocked and open the door.
At the Point of Disclosure
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The first thing people tend to do subconsciously is to observe the doctor’s expression and their opening statement. Sometimes, you kind of size up the outcome of your result within one minute assessment of those nonverbal. However, do note that doctors break bad news every other day. Hence, it is plausible for them to disclose bad news mechanically, even if that isn’t what they think they are doing. This may be true especially if the doctor is being swarmed with patients every day; your case is probably another one of the many cases seen by them.
Disclosure of bad news from the doctor can be quite overwhelming. There are two common factors. Firstly, you are trying to crunch the sheer amount of medical information shared within a short span of time. If your feelings does not steer you into a state of shock, you would be able to make something useful out of the brief conversation.
On the other hand, there are also a handful of people who can become emotionally overwhelmed by the bad news. At that state, you are probably not able to register much information in that limited time. And you could be staring blankly at the doctor’s mouthful of information while your brain gradually become choked with your own quiet concerns.
It is also highly recommended that you read the 3 Types of Doctor’s Relationship You Might Experience In your Lifetime to get some idea on the kind of doctors you prefer to have.
I will share about 3 common things that may happen simultaneously during breaking of bad news. This also applies to diseases that are potentially life-threatening.
1. Sibei (Very) Technical
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Doctors may end up becoming technical in their explanation, which can makes comprehension challenging. As a fair comment, some of these terms may be common to the healthcare industry, so in the mind of some doctors, these are already very basic terms (e.g. abdomen). However to the man on the street, it may be a different thing (e.g. tummy).
Sometimes, the fault may lie in translation of explanation into different language. The process of translation may make well intended explanation appear to be very technical, foreign or scary. Especially if proficiency in that language isn’t strong. Every extra ‘err, erm or ah’ can be mistakenly judged for trying to cushion the impact of unfavourable condition. Intentional or not.
Always request to translate medical jargons into layman terms. Sometimes, we assume we understand what the doctor is saying only to realise that we really don’t after the session.
A simple trick is to paraphase what the doctor says to you into what you understand.
“Doctor did you mean…”
“Are you saying…”
2. Fighting Against Time
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While you are digesting new information, you are also trying to construct questions. This can be difficult for many people, especially when time is short. Or you find yourself firing too many questions at the doctor (some which may not be medical in nature) and the doctor doesn’t have the time (or he is not the right person to answer some of your question).
Regardless of types, as a first date, you probably wished you had more time with your doctor.
It is normal to realise that you have tons of questions only after the first session. Don’t beat yourself over this. There are always subsequent sessions for those.
Always prioritise your questions: your time with your doctor is always limited.
Keeping a checklist of questions is always helpful.
3. Emotions over Matter
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Other than clarification of questions, at the same time, we are also trying to manage the emotions that may be arising within us. Feelings are involuntary. It is not something that we can stop ourselves from feeling. Having fear and anxiety about what would happen next is only human.
Some people are predisposed to anxiety and/or depression. This may be true for those with history of mental health concerns.
If you belong to the category of people who finds it hard to manage your emotions, you might want to consider bringing a family member (or someone you trust) who is able to help you suss out those details and be part of those sessions.
If you have to face this alone, then just take whatever you can absorb for that session and find someone you trust to process with you.
Alternatively, you could also request to speak with a medical social worker in the hospital or seek help from cancer organisation such as Singapore Cancer Society.
Post-Exit from the Doctor’s Room
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Cancer are often associated with death because it is the top principal cause of death in Singapore. In 2017, 29.1% of all death are due to cancer.
The good news is that cancer survivorship has been improving over the years and early detection do matter.
However, the truth is that we still can’t shake off cancer for good. Which is why, we need to learn how to live along side with it.
Featured Photo by Anton Darius | @theSollers on Unsplash