How Are You, Really?

How Are You, Really?

Talking with Your Doctor about the Side Effects of Cancer Treatment

by Jolyn Taylor, MD, MPH and Lois Ramondetta, MD

How are you? This is often the first thing a doctor says when you arrive for an appointment. While it’s a simple question, it’s one that can be difficult to answer. After all, most people battling cancer are likely experiencing a multitude of symptoms and side effects, with some more troubling than others. Should you report all of your symptoms? Only some of them? Which ones? 

On top of that, the medical profession doesn’t always make it easy to report symptoms and side effects. While most providers spend years improving surgical techniques, and countless hours keeping up with the latest medical research, an inconsistent amount of time is allotted to training oncologists on how to identify and improve disease- and treatment-related symptoms and side effects. In addition, when a person reports a symptom or a side effect to his or her doctor, these reports are commonly referred to as “complaints” in medical documentation. Though this isn’t meant to be a negative thing, the language used can give off that connotation, causing some people to be hesitant in reporting even their more troubling symptoms because they don’t want to be seen as weak or “complaining.”  

However, reporting symptoms and side effects is not a sign of weakness. Think about it. Does admitting that you have trouble getting a good night’s sleep mean you are “giving in” to cancer? Does acknowledging that your pain is too great to handle without intervention mean that the disease is winning? Of course not. There is no winning or losing against the symptoms and side effects that accompany a disease like cancer. There is only managing and treating them. 

Also, reporting your symptoms and side effects is not “complaining.” And it doesn’t create an unnecessary burden for your doctor. In fact, the opposite is true. In order for your doctor to address the symptoms and side effects that are diminishing your quality of life, he or she needs to know what matters most to you. Explaining exactly how the side effects of cancer treatment are affecting your life is never complaining. Rather, it’s building a stronger bridge of communication between you and your doctor. Maintaining an open dialog with your doctor is essential to achieving an optimal quality of life during and after cancer treatment. 

The Importance of Palliative Care in Cancer Treatment

Palliative care (sometimes called supportive care) is a clinical service that focuses on relieving the symptoms caused by cancer, as well as the side effects of cancer treatment. 

In 2012, the American Society of Clinical Oncology released a provisional clinical opinion on the timing and use of palliative care services for people with cancer. The report recommended that palliative care be combined with standard oncologic practice early in the disease course in order to improve quality of life for cancer survivors. There is quite a bit of data to back up this  recommendation. For example, among gynecologic oncology patients, collaboration with palliative care services has been shown to decrease the symptom burden by half within one day of consultation.

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So the next time your doctor asks how you are, take a moment to answer honestly and completely. After all, what your doctor likely wants to know is “How are you, really?”

Dr. Jolyn Taylor

Dr. Jolyn Taylor (left) completed her medical doctorate at New York University School of Medicine and her residency in Obstetrics and Gynecology at Weill Cornell Medical College. She is now a fellow in Gynecologic Oncology at The University of Texas MD Anderson Cancer Center, in Houston, TX.

Dr. Lois Ramondetta

Dr. Lois Ramondetta (right) is a professor of Gynecologic Oncology and Reproductive Medicine at MD Anderson and is co-leader of the initiative targeting cancers associated with HPV in MD Anderson’s Moon Shots Program. She is also a member of NRG Oncology’s Cervix Committee, as well as the Cervical Task Force of the National Cancer Institute’s Gynecologic Cancer Steering Committee.

This article was published in Coping® with Cancer magazine, September/October 2016.