Waiting for appointments and test results can turn living with cancer into a full-time occupation and preoccupation.
The doomsday scenarios you conjure up during stressful waiting periods are usually far worse than reality.
You count the weeks and days until your next appointment and make note of every ache and pain, thinking it might be a signal that your disease is worsening. On the day of your appointment, you are so anxious that you arrive early at your physician’s office, only to discover that he is behind schedule, increasing your waiting time as well as your apprehension. During your visit, your physician orders the required tests and tells you to go home and wait for a phone call—or suggests that you call back in a few days or a week to get your test results.
You are always waiting for something: the initial diagnosis following surgery; a biopsy, mammogram, or fine needle aspiration; the results of treatment; and when in remission, your next checkup. The most difficult aspect of waiting is the openended uncertainty of not knowing what is happening inside your body. Conversely, “knowing” can be a relief—even when the news is not good—because you and your physician then can take action and discuss therapeutic alternatives.
You should also be aware that the time you spend waiting for appointments and for information on your medical status is often determined by circumstances beyond your control or that of your physician. For example, because of economic pressures, most physicians see more people per hour today than they saw in the past, resulting in shorter office visits. This can make you feel that you have received insufficient consideration of your psychosocial needs. Physicians’ increasingly heavy workloads also lead to longer waiting periods for an appointment, whether for an initial consultation or for subsequent therapy.
The operating procedures of insurance companies and Health Maintenance Organizations (HMOs) can also lead to delays that, in turn, increase your apprehension. These organizations generally require that physicians obtain an authorization from them before ordering certain types of tests, therapies, and surgical procedures. You or your primary physician must also request permission from the insurance company or HMO to consult with a specialist and you must, of course, choose one who belongs to your plan. If you choose a specialist who is not on your plan, you may find that the plan will not pay (or will pay less) for the services. Any or all of these negotiations can mean added hours or days of fretfulness for you.
In short, facing delays is a part of the treatment of cancer, but with a little mutual understanding and effort, you and your physician can attempt to lessen those that are occasioned by heavy patient loads, complex diagnostic tests, and insurance company and HMO requirements. Hopefully, in the last instance, future legislative action will streamline some of the medical management procedures that currently prolong certain waiting periods and exacerbate what is already a highly stressful time in anyone’s life.
Reprinted by permission from Coping magazine.
Ernest H. Rosenbaum, M.D.
Clinical Professor of Medicine, University of California, San Francisco, Comprehensive Cancer Center; Adjunct Clinical Professor, Department of Medicine, Stanford University Medical Center; Director, Stanford Cancer Supportive Care Programs National/International, Stanford Complementary Medicine Clinic, Stanford University Medical Center, Stanford, California. More
Ernest H. Rosenbaum’s career has included a fellowship at the Blood Research Laboratory of Tufts University School of Medicine (New England Center Hospital) and MIT. He teaches at the University of California, San Francisco, Comprehensive Cancer Center, was the cofounder of the Northern California Academy of Clinical Oncology, and founded the Better Health Foundation and the Cancer Supportive Care Program at the Stanford Complementary Medicine Clinic, Stanford University Medical Center.
His passionate interest in clinical research and developing ways to improve patient care and communication with patients and colleagues has resulted in over fifty articles on cancer and hematology in various medical journals. He has also participated in many radio and television programs and frequently lectures to medical and public groups.
He has written numerous books, including Living with Cancer: A Home Care Training Program for Cancer Patients; Decisions for Life: You Can Live Ten Years Longer with Better Health; Cancer Supportive Care: A Comprehensive Guide for Cancer Patients and Their Families; Nutrition for the Cancer Patient; Everyone’s Guide to Cancer Therapy; and Everyone’s Guide to Cancer Survivorship. For Everyone’s Guide to Cancer Therapy, Ernest Rosenbaum, M.D., Malin Dollinger, M.D., and Greg Cable received and Honorable Mention in 1991 from the American Medical Writers Association for Excellence in Medical Publications. Ernest and Isadora Rosenbaum received the same award in 1982 for their book, A Comprehensive Guide for Cancer Patients and Their Families.
Isadora Rosenbaum, M.A.
Isadora Rosenbaum is a medical assistant who worked in immunology research and is currently at an oncology practice at the UCSF Comprehensive Cancer Center offering advice and psychosocial support. She coauthored Nutrition for the Cancer Patient and The Comprehensive Guide for Cancer Patients and Their Families. She has written chapters in Everyone’s Guide to Cancer Therapy, Living with Cancer, and You Can Live 10 Years Longer with Better Health.