Medical Program: Counseling Strategies in NSCLC Care: Helping Patients Cope with a Diagnosis

Announcer:
Welcome to Closing the Gaps in Non-Small Cell Lung Cancer on ReachMD, sponsored by Lilly.

On today’s program, we’ll hear from Dr. Jacob Sands, who’s a thoracic medical oncologist at the Dana-Farber Cancer Institute and an Instructor of Medicine at Harvard Medical School. Dr. Sands joins us to discuss the counseling strategies he uses to help his patients cope with a lung cancer diagnosis. Let’s hear from him now.

Dr. Sands:
In oncology we often see just the initial diagnosis itself as an unexpected challenge. Patients show up in the clinic really feeling like this is a life collision in a sense of this sudden diagnosis and their world has turned upside down. Patients come in with a lot of beliefs of what cancer and what that means, and I find that the most important thing is really to address that from the very beginning and to address that head on. And to me, that really gets at the core of, I think, addressing unexpected challenges, which is really to make sure that you’re being very direct in interacting with patients, being very direct in your answers. I tell patients I don’t ever want them to feel like they have to read my facial expressions or see what I’m not telling them. I will always tell them. If I have thoughts about stuff, I tell them, and I try and be as direct as I can in answering things.

At the same time, a really important part of this, is making sure that they know you care. That above everything, you care. That you want to see them do well, but you want to help them achieve what it is they want to achieve within the confines of the reality of the situation. And so, I guess, patients come in, often in an emotional experience. And we, on the medical side, tend to think of everything in an intellectual way. And so, sometimes when you’re talking about everything intellectually, but patients are experiencing everything and, therefore, interacting emotionally, those end up being very different parts of the brain, and it can really be hard to communicate, effectively in those situations. So one of the greatest challenge is to try to read patients and better understand where they’re at sometimes when they don’t fully understand that and then being very direct, in observations of that or statements about what’s going on while also an overlay to everything is making sure that they know that you care. That you are thinking about them. That you are always trying to figure out better ways of treating them or better options, while also being very direct about the situation. So then as part of that counseling in the initial visit, there’s talking about treatment options and in lung cancer, you know, especially for nonsquamous, non-small cell, they are often other labs that we want to get back before we’re doing treatment.

So, a challenging scenario is patients now have gotten this diagnosis. They’re having this emotional experience. They’re often scared, understandably so. And so they’re ready to get started right now. But in many cases, we need to get some labs back or other test results to really best know how to treat them. And so a challenge can be then how to explain to patients that there’s more workup to do before getting started. And one of the things that I’ll say to patients is that we really want to use the best treatment not the first treatment. And I find that that is a short statement that helps patients understand why you’re doing this other stuff and to them what feels like delay before getting started.

Announcer:
That was Dr. Jacob Sands sharing the strategies he uses when counseling his newly diagnosed lung cancer patients.  To revisit any part of this discussion and to access other episodes in this series, visit ReachMD.com/NSCLC, where you can Be Part of the Knowledge. Thanks for listening!