of stress and anxiety in the patient , and that first meeting is so important . It ’ s important just to get to know and “ connect ” with the patient ,” he said .
“ In that first meeting , it is important to lighten the mood as much as possible . ‘ You ’ re born the same year as me !’, ‘ Your daughter is the same age as my daughter . Where did she study ?’ You ’ re trying to make a connection with the patient as quickly as possible .”
Every patient comes in with a different expectation . Some patients are very well-read , and they know everything there is to know about their cancer , whereas others are not yet ready to know too much . For this second group in particular , the doctor has to quickly gauge the pace that works best in relation to the patient ’ s emotional state .
Knowing the right way to describe what could be a turning point in somebody ’ s life is essential , and comes with experience .
It is important to carefully assess each individual before deciding when to reveal and how much to say about the disease . Some patients want to know and are ready to know everything , including how serious the cancer is , whether it is incurable and how much time they have left .
Others may choose not to know too much and just want to get along with the treatment and hope for the best .
“ That ’ s why it ’ s important to have this understanding established as quickly as possible . If not , the patient may go away feeling unhappy with too little or too much information ,” said Dr Ang .
He recently saw the result of poor messaging when an elderly woman with late-stage cancer arrived in his clinic . The last time she had seen a doctor , a year previously , was after she had encountered a small breast lump . At that meeting , her doctor told to “ get her family together .”
“ The way she perceived it , the doctor had said that the cancer was terminal and there was nothing that could be done . She thought she was just being advised to spend her final days with those closest to her ,” said Dr Ang .
“ However , what the doctor probably meant to say was that she should involve her family in the decision-making and seek their support during the treatment process .” This misunderstanding resulted in the patient hiding the condition from her family , delaying treating and resulting in the cancer becoming advanced stage disease .
The best oncologists have good mentors from whom they learn how to nurture relationships with their patients and communicate effectively .
The lesson that specialists should learn is that , no matter how they approach treatment , they must have their patient ’ s best interest at heart , and they must provide comfort , no matter how bad the patient ’ s situation is .
“ Comforting a patient is a very important aspect of being an oncologist ,” said Dr Ang .
“ In my training , I have followed some of the greats in oncology , and you could see that despite their brilliance , their knowledge and their fame , one thing they had in common was their compassion for the patient . That is something that no one can ever teach you directly ; you have to learn it simply by observing and emulating them .”
As modern healthcare evolves , the reality is that the treatment of cancer has become more intrinsically based on protocols - long lists of steps that doctors check off at each stage of diagnosis , treatment and assessment .
In actual fact , most doctors recognise that it is the “ art ” of medicine , as much as the “ science ” which consists of research data and treatment protocols , that separates the good practitioners from the best .
“ Any medical student can flip through treatment guidelines and know what to do . At Parkway Cancer Centre , we always remind each other it is the other half of what we do that makes the difference ,” said Dr Ang .
“ It ’ s why the patients will come back to us time and again . Many of our referrals come from family members and friends of our patients . They recognise that we have done our best for their loved ones and trust that we shall continue to do so .”
As much as oncologists hope to cure all their patients , we often cannot . The large majority of cancer patients present late-stage disease , and no matter how advanced cancer treatment has become , oncologists can often only control the disease , preserve quality-of-life and prolong meaningful life . Most patients with advanced stage and metastatic cancer will eventually die because of the cancer . The doctor must be able to journey alongside the patient , do his best in treating the cancer and provide the much needed psychological support . As we approach the end of life , it is the comfort that we provide that inspires hope and peace in patients and their families .
“ It ’ s so important to show that you don ’ t just know the science of medicine , but you practice the art of it . That ’ s what we must do as oncologists ,” said Dr Ang .
Make an appointment to consult an oncologist at Parkway Cancer Centre
Phone appointment : + 65 6737 0733 Online appointment : www . parkwaycancercentre . com
Dr Ang Peng Tiam is the medical director of the Parkway Cancer Centre in Singapore . He is a council member of the Singapore Cancer Society and the past president of the Singapore Society of Oncology . He held the concurrent post of Director of the Oncology Centre and Clinical Associate Professor at the Faculty of Medicine of the National University of Singapore .
GlobalHealthAsiaPacific . com DECEMBER 2021 - JANUARY 2022