A cancer diagnosis comes as a shock; it is a life- changing event and can cause chaos and anxiety. Dr David Eedes, an oncology advisor to Icon Oncology - a network of 80% of the all oncologists in private practice in South Africa - offers tips to help you manage this emotionally difficult time.
Start with a plan and involve friends and family
Your treating specialists are there to assist in understanding the situation and planning further investigations and proposed treatment. Initially you can feel overwhelmed by all the information you receive - ask a trusted friend or family member to accompany you to your visits.
They’ll be a source of support, can help remember and make sense of what is said and take notes for later reference. Take a list of questions to your consultation, record your consultations and ask your friend to remind you of important questions you might forget.
Keep it simple
Avoid consulting “Dr Google” and arriving with a preference towards a certain kind of treatment; allow your consulting specialist to follow standard consultation procedures - this avoids missing important steps and gives structure to your consultation. Once the time for discussion comes, your questions, treatment preferences and wishes can be discussed.
You might need a follow-up consultation
Further tests are often needed before the oncologist forms a clear picture of your particular situation and a more detailed discussion can follow. If the first doctor you consult is not a good personal fit, or your questions are not answered, seek a second opinion - your GP or referring doctor can help.
Understanding your cancer type and stage
Cancers are staged 1 – 4 according to where it started and how much it has spread to other body areas. In a common cancer like breast cancer, spreading to the lymph glands under the armpit or to other parts of the body indicate the stage of cancer and allow the oncologist to give the patient a treatment option and the longer term prognosis.
Preparing for treatment
The specialist will then discuss what they believe the best treatment plan is. They may recommend specialised tests to determine your cancer’s characteristics; this may help refine treatment choices. Depending on what has been done to date, a biopsy or operation to remove the cancer may be recommended.
Specialised blood tests and radiology - X-rays, ultrasounds, MRIs or PET scans – might also be needed.
A treatment plan that is unique to you will be recommended, taking into account your lifestyle, age, other illnesses, and your personal wishes. While you’ll find information about different treatment types online, they are not always a good fit. Your doctor will explain why they believe their recommend treatment plan is the right route. Your case might also be discussed with a team of doctors who will evaluate your case.
Your opinion and wishes still matter and you might want to ask about other options and decide with the oncologist what treatment you’d prefer. This may be a compromise and you need to be clear what the downsides of not taking the oncologist’s advice are.
Your doctor will share printed or online information - remember to discuss the treatment with the practice nurse as they are often a wealth of information. Also note any questions as this material can be technical and you may want to ask more detailed questions from your treatment team such as hair loss or how to plan time off work, if you can exercise an if you have to adjust your diet.
If you’re a younger patient, fertility could be of concern. First establish what the risk is and then look at your options. Sperm banking for men or egg preservation for women needs to be discussed before treatment starts.
Covering the cost of cancer
Once you’ve been diagnosed contact your medical scheme to understand exactly what scheme option you are on and what your benefits are. They can also inform you of processes to register on their oncology programme, give details of authorisation processes and advise if there are any hospital or treatment centre restrictions. Consult your insurance broker; you may have a life insurance policy with a dread disease cover or gap cover insurance.
There may be shortfalls in costs associated with your treatments or restrictions on your ability to generate an income. You can also fund it yourself; upgrade your medical scheme option to be able to access more expensive treatments that your current option may not cover or access a clinical trial that might have new treatment options not yet available locally.