Skip to main content

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?
 


Comments

Popular posts from this blog

Becoming a Part-Time Physician

Next month my schedule will change.  I will henceforth be off on Fridays with my work week truncated to Monday through Thursday.   I am excited to be enjoying a long weekend every weekend.  And while the schedule change is relatively minor, this event does feel like an important career moment for me.  It is the first step on a journey that will ultimately lead beyond my professional career.  It is this recognition that makes this modest schedule modification more significant than one would think it deserves.  As some readers know,   my current employed position has been a dream job for me.   Prior to this, I was in a small private practice, which I loved, but was much more challenging professionally and personally.   My partner and I ran the business.   Working nights, weekends and holidays were routine for decades.   On an on-call night, if I slept  through until morning, I felt as if I had won the lottery.   And w...

When Should Doctors Retire?

I am asked with some regularity whether I am aiming to retire in the near term.  Years ago, I never received such inquiries.  Why now?   Might it be because my coiffure and goatee – although finely-manicured – has long entered the gray area?  Could it be because many other even younger physicians have given up their stethoscopes for lives of leisure? (Hopefully, my inquiring patients are not suspecting me of professional performance lapses!) Interestingly, a nurse in my office recently approached me and asked me sotto voce that she heard I was retiring.    “Interesting,” I remarked.   Since I was unaware of this retirement news, I asked her when would be my last day at work.   I have no idea where this erroneous rumor originated from.   I requested that my nurse-friend contact her flawed intel source and set him or her straight.   Retirement might seem tempting to me as I have so many other interests.   Indeed, reading and ...

Personal Responsibility for Health

One of the advantages of the computer era is that patients and physicians can communicate via a portal system.  A patient can submit an inquiry which I typically respond to promptly.  It also offers me the opportunity to provide advice or test results to patients.  Moreover, the system documents that the patient has in fact read my message.  Beyond the medical value, it also provides some legal protection if it is later alleged that ‘my doctor never sent me my results’.  I have always endorsed the concept that patients must accept personal responsibility.   Consider this hypothetical example. A patient undergoes a screening colonoscopy and a polyp is removed.   The patient is told to expect a portal message detailing the results in the coming days.   Once the analysis of the polyp has been completed, the doctor sends a message via the portal communicating that the polyp is benign, but is regarded as ‘precancerous'.   The patient is advise...