Saturday, January 7, 2017

How & Where do You Want to Receive Your Biopsy Results?

This blog appeared on Prostate Cancer News Today on 10/24/16 on this link:
Receiving Your Biopsy Results

In my previous column, I talked about the first phase after a biopsy — the waiting. Here, I’m looking at phase two, which begins the day you receive your results.
In a study titled Disclosing a Diagnosis of Cancer: Where and How Does It Occur?, researchers reported on a survey given to hundreds of cancer patients being treated at a National Cancer Institute center in Maryland. Their findings:  “Of  the 437 patients who completed the survey, 54% were told their diagnosis in-person in the physician’s office, 18% by phone, and 28% in the hospital. Forty-four percent of patients reported discussions of 10 minutes or fewer, 53% reported discussions lasting longer than 10 minutes, and 5% could not remember … Higher mean satisfaction scores were associated with diagnoses revealed in person rather than over the phone.”
I wanted some influence as to where and how I’d receive my biopsy results.   
The Where — I did not want to receive the news in my doctor’s office. Part of that decision involved my not wanting to drive 30 miles home if the news confirmed my suspicion of having prostate cancer. I wanted to hear the news in the safety and security of my home.
I’m in the minority. Most people prefer to be told their results in their doctor’s office.
The How — After the biopsy procedure, I asked my doctor if he’d call me with the results. He agreed to do this. I anticipated that I’d get about 10 minutes of his time.
To use that time efficiently, I decided to prepare a list of questions in advance. As it turns out, my list contained one question: I wanted to know my Gleason score.
The Call — My phone rang at 7:30 on a Sunday morning. In my life, early morning phone calls usually involve an emergency or bad news.
It was my urologist. I was struck by his tone of voice when he asked, “Am I speaking to Richard Redner?” I knew beyond a shadow of a doubt he was about to tell me I had prostate cancer.
My wife, Brenda, was sleeping at the time. I ran upstairs, woke her up, and told her I was speaking to my urologist about my biopsy results. I put the phone on speaker and told him I was ready.
He said, “I regret to inform you that you have prostate cancer.” He didn’t say this, but I imagined I heard it loud and clear: “You’ll be dead within a year.”  I asked my only question. “What are my Gleason scores?” He said three cores were 4+3, the others were 3+3. I was confused. I thought all cores would have the same score, so I asked him “What does this mean?” He said, “You have a moderately aggressive cancer.” My filter deleted the word “moderately.”
My Suggestions:
• Ask your doctor if treatment options are discussed on the same day you receive your biopsy results, or whether that will require another appointment.                                                                                                                                             • Bring your partner, a friend, or family member to the meeting, rather than receive the news alone.
• Decide how, when, and where you want to receive your biopsy results. Write a list of questions you’d like answered.
• Take notes or record your Gleason score, and all the answers to your list of questions. You’d be surprised how much you’ll forget.