Signs and Symptoms of Cancer

"Doctor, do you think I have cancer?"

In a prior post, I did my best to point out that handling questions from patients and their families in a skillful manner requires a measured and cautious approach. Paradoxically, physicians have not received much training, if any, in this aspect of doctoring, which physicians engage in dozens of times each day. In the unlikely event that you have not yet perused the prior post, here’s the link, which will serve as a brief prep course for this current posting.

All of us hope and pray for a salubrious life. Sickness scares us. We fear any worsening of our illnesses, future mental decline, loss of physical function or any unforeseen change in our medical fortunes. The fear of cancer hovers over all of us. And, understandably, patients want to be reassured that their symptoms are benign and transient.

There is another genre of questions that are directed at physicians that requires a deft response. Below, I will list some hypothetical queries that every physician hears regularly. And, in most cases, we simply cannot offer the desired response.

Cancer Phobia is Everywhere

Picture above - Lung Cancer is a White Lesion

Physicians are imperfect and cannot see beyond the present. We cannot deliver clarity to every inquiry. We cannot resolve all doubts when you ask us questions such as these.

Doctor, are you sure it’s not serious?
My cousin has the same symptoms as I have, and she was diagnosed with lupus. Could I have lupus?
Will my pain be gone if I go through the operation?
As long as you tell me it’s not cancer, I’ll be fine.
I know you said my back pain was just arthritis, but It’s been 3 weeks and I’m no better. Do you think it could be more than just arthritis?

It is not possible to respond to questions like this definitively, because the medical universe does not operate in absolute and quantitative terms. It’s nuanced and amorphous. This is why seasoned practitioners are careful with their language. We use phrasing such as, “…it would be very unlikely that”, “…your symptoms are not typical for”, or “…in my experience cases like yours usually resolve on their own”. In other words, we leave the door open a crack. Why? Because it’s the best we can do and we want to maintain our trust and credibility with you.

Any questions?

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