I am always asked “what if?” When my patients are seeking the pessimistic alternative to the situation at hand. I have also heard of patients being given ultimatums with a deadline on their time to life. I love it when they break those barriers and surpass the times “allocated”. I have not handled these questions or these situations well. I touch upon my need to provide the right answer when I am asked “what if that happens to me?” and “when will it happen to me?” My tendency is to avoid it, try not to answer it and tonight I wonder why I do that.
Our predictive power as oncologists is very limited. In 2013 I am faced with an enormous speed at which we are discovering newer more innovative therapies to help patients. I find it hard to counsel patients in the future when there is hope for cures and longevity. This is very new for me, exciting and frightening all at once.
How does it feel for my patient? Anxiety is one of the most difficult emotions to navigate. Failing to provide them with the answers they seek creates a conflict that is not readily resolved. Science needs to help us understand outcomes of how disease may manifest in an individual and how it acts. A lot of our therapies are geared towards attacking the cancer head on. Newer approaches are taking into account how we might be able to isolate different individuals based on the behavior of their bodies and discovering better predictors for response to a therapy. I would like to tell my patient “I’m recommending this therapy because you are the one who will benefit from it.” We are clearly not there, and a lot of work needs to be done to help us be better at guiding patients down the best path for the treatment of their disease.
Like a compass leading in a general direction without pointing to a specific street or alley, when asked “Well what if that does not work for me what then?” I simply say – we’ll take it day by day and cross that bridge when and if we get there.