Delivering Bad News - What not to do...

UT Health San Antonio – Video Production

4 Feb 201304:24

Summary

TLDRIn the video, Mrs. FLOTUS learns she has invasive, metastatic breast cancer that is estrogen receptor positive, indicating a response to hormonal therapy. Despite her shock and fear, the doctor assures her of available treatment options including surgery, radiation, and chemotherapy. The doctor's empathy and promise of support, along with the mention of a successful family member's recovery, aim to comfort Mrs. FLOTUS as she faces this health challenge.

Takeaways

🏥 Mrs. FLOTUS is diagnosed with invasive breast cancer that has metastasized to her lymph nodes.
🌟 The cancer is estrogen receptor positive, which indicates a better response to hormonal therapy.
🔍 The patient has been experiencing symptoms such as fatigue, dizziness, and has discovered a lump.
👩‍⚕️ The doctor recommends meeting with a medical oncology team and a general surgery consultation.
🔪 Possible surgical treatments include a mastectomy or a lumpectomy, to be followed by radiation and chemotherapy.
🧬 The cancer was undetectable at stage one and is prevalent in the Hispanic population, as mentioned by the doctor.
💪 The doctor encourages Mrs. FLOTUS to remain strong and assures her that there are many treatment options available.
🏋️‍♀️ The patient is described as very active, which could be beneficial for her recovery process.
😢 The patient expresses fear and concern about the pain and suffering similar to what her husband experienced with colon cancer.
🤝 The doctor offers emotional support and mentions a personal connection through a family member who survived breast cancer.

Q & A

What health issues is Mrs. FLOTUS experiencing?
-Mrs. FLOTUS is experiencing fatigue, dizziness when she gets overly tired, and she has a lump that she is concerned about.
What tests has Mrs. FLOTUS undergone?
-Mrs. FLOTUS has undergone a CBC (Complete Blood Count), a comprehensive metabolic panel, and a mammogram.
What is the diagnosis given to Mrs. FLOTUS by the doctor?
-The doctor diagnoses Mrs. FLOTUS with invasive breast cancer that has metastasized to her lymph nodes.
What does 'estrogen receptor positive' mean in the context of breast cancer?
-Being 'estrogen receptor positive' means that the cancer cells have receptors for estrogen, which is a good thing because it indicates that the cancer is likely to respond to hormonal therapy.
What is the initial reaction of Mrs. FLOTUS upon hearing her diagnosis?
-Mrs. FLOTUS is in disbelief and shock, stating that no one in her family has had cancer.
What treatment options are suggested for Mrs. FLOTUS?
-The suggested treatment options include meeting with a medical oncology team and a general surgery consultation for a possible mastectomy or lumpectomy, followed by radiation therapy and chemotherapy.
Why does the doctor say that the cancer was undetectable at stage one?
-The doctor indicates that Mrs. FLOTUS's cancer was very insidious and undetectable at stage one, suggesting that it was not easily identifiable or noticeable at an early stage.
How does the doctor address Mrs. FLOTUS's concern about being in pain like her husband?
-The doctor reassures Mrs. FLOTUS that she will be fine and that there are many cancer survivors. The doctor also empathizes with her feelings and offers to set up a meeting in a few months.
What is the doctor's response to Mrs. FLOTUS's fear and concern about dying?
-The doctor assures Mrs. FLOTUS that she is not dying and that there are plenty of treatment options available. The doctor also refers her to the best medical oncologist in town.
What is the doctor's plan to support Mrs. FLOTUS moving forward?
-The doctor plans to refer Mrs. FLOTUS to the medical oncology team and offers to set up a meeting with her in six months. Additionally, the doctor calls in the nurse practitioner, Bonnie, to answer any further questions Mrs. FLOTUS may have.
What is the significance of the doctor mentioning her Aunt Marie's experience with breast cancer?
-The doctor mentions her Aunt Marie's successful treatment of breast cancer to provide Mrs. FLOTUS with a positive example and to reassure her that recovery is possible.

Outlines

00:00

🏥 Diagnosing Breast Cancer

In this paragraph, a patient named Mrs. FLOTUS is discussing her health concerns with her doctor. She reports feeling very tired and dizzy, and mentions a lump that she is scared about. The doctor informs her that she has invasive breast cancer that has metastasized to her lymph nodes. The cancer is estrogen receptor positive, which indicates that hormonal therapy will be effective. The doctor suggests meeting with a medical oncology team and a general surgeon to discuss treatment options, which may include a mastectomy or lumpectomy, followed by radiation therapy and chemotherapy. The patient expresses shock and disbelief, questioning how she could have cancer given her regular check-ups. The doctor reassures her about the availability of treatment options and the strength of cancer survivors, including a personal connection with the doctor's Aunt Marie.

Mindmap

Keywords

💡Invasive breast cancer

Invasive breast cancer is a type of cancer where the abnormal cells have the ability to invade and spread into surrounding tissues. In the script, Mrs. FLOTUS is diagnosed with this type of cancer, which is a serious condition that requires immediate medical attention. The term is crucial as it sets the stage for the discussion of treatment options and the gravity of the situation.

💡Metastatic

Metastatic refers to the spread of cancer from its original site to other parts of the body. In the context of the video, the cancer has metastasized to the lymph nodes, indicating a more advanced stage of the disease. This term is significant as it influences the prognosis and the urgency of treatment.

💡Estrogen receptor positive

Estrogen receptor positive is a term used to describe a type of breast cancer that is fueled by estrogen. In the script, the doctor mentions this as a 'good thing' because it means the patient will likely respond well to hormonal therapy. This is a key concept as it influences the treatment approach and offers a ray of hope for the patient.

💡Mammogram

A mammogram is an X-ray examination of the breast used to screen for breast cancer or to diagnose the disease. In the video, Mrs. FLOTUS mentions keeping her mammogram schedule, which is a preventive measure to detect breast cancer early. The term is important as it highlights the importance of regular screenings.

💡Lumpectomy

Lumpectomy is a surgical procedure to remove the cancerous tumor along with a small margin of healthy tissue. The script mentions this as a probable recommendation by the medical team, indicating a common treatment for breast cancer. It's a significant term as it represents one of the surgical options available to the patient.

💡Mastectomy

Mastectomy is a surgical procedure to remove the entire breast, often done when cancer is extensive. The doctor in the script suggests this as a possible treatment, which is a critical term as it represents a more radical surgical intervention for breast cancer.

💡Radiation therapy

Radiation therapy uses high-energy rays to kill cancer cells or stop them from growing. The script mentions this as a follow-up treatment after surgery, which is an essential part of the comprehensive treatment plan for breast cancer. This term is important as it represents a non-surgical treatment method.

💡Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. It is mentioned in the script as another part of the treatment plan, which is crucial as it helps to eliminate any remaining cancer cells after surgery.

💡Medical oncology team

A medical oncology team consists of specialists who treat cancer using medications and other therapies. The doctor in the script refers Mrs. FLOTUS to such a team, which is a key term as it signifies the multidisciplinary approach to cancer treatment.

💡Insidious

Insidious means something that develops in a gradual and subtle way, often without being noticed. The doctor uses this term to describe the cancer's progression, which is significant as it underscores the stealthy nature of the disease and the importance of regular check-ups.

💡Cancer survivor

A cancer survivor is someone who has been diagnosed with cancer and has lived beyond the diagnosis, often in remission. The doctor mentions cancer survivors to reassure Mrs. FLOTUS, which is an important term as it brings hope and a sense of community to the patient.

Highlights

Patient reports feeling very tired and experiencing dizziness when overly tired.

Patient mentions having a lump and expresses fear.

Doctor reveals the diagnosis of invasive breast cancer.

Cancer has metastasized to the lymph nodes.

Cancer is estrogen receptor positive, indicating a response to hormonal therapy.

Patient expresses disbelief and concern about family history.

Doctor outlines the next steps including meeting with a medical oncology team and general surgery.

Surgical options of mastectomy or lumpectomy are mentioned.

Radiation therapy and chemotherapy are part of the treatment plan.

Patient is confused and scared, only hears 'breast cancer'.

Doctor explains the seriousness of the tumor and its potential to spread quickly.

Doctor reassures the patient that the cancer was undetectable at stage one.

Breast cancer is highlighted as prevalent in the Hispanic population.

Doctor encourages the patient to remain strong.

Patient expresses fear of dying.

Doctor assures the patient of available treatment options and refers to a top medical oncologist.

Patient shares her fear of pain, referencing her husband's experience with colon cancer.

Doctor empathizes and offers to set up a meeting in six months.

Doctor calls in nurse practitioner Bonnie for additional support and questions.