How do I deal with a patient with hereditary cancer?
Breast cancer, colon cancer, ovarian cancer, pancreatic cancer…the list of hereditary cancers is long. If you have a patient with a hereditary cancer, take the time to talk to her. Most of the time, she’ll have a list of concerns that goes far beyond her physical recovery.
Patients with a hereditary cancer may have horrific memories of a parent’s or grandparent’s death. They may recall in great detail how grandma retched for days after chemotherapy treatments, or how a loved one passed on not long after a cancer diagnosis. Listen to your patient’s stories; talking about her family’s experience may help her integrate her own cancer diagnosis. Her stories may also give you an idea of her fears. If she talks about her grandmother’s reaction to chemotherapy, seize that opportunity to talk about advances in treatment. Let her know that newer anti-emetics keep most patients relatively comfortable, even through bouts of intense chemotherapy.
If your patient has children, she’s probably worried about their well being, too. Many patients with hereditary cancer feel a tremendous amount of guilt, as if they’ve passed along the DNA of destruction. Again, listen to your patients’ fears, but offer concrete information. If appropriate, connect your patient with a genetic counselor. The counselor can provide statistical information and refer patients and families for genetic testing, if desired.
Above all, reassure your patient. Hereditary cancer is not a curse passed down from generation to generation. It’s a disease, just like any other. The only difference is that patients and families with hereditary cancer now have more information than ever before. Armed with information, some patients—and family members—can take steps to prevent the next cancer, and that’s a very good thing indeed.