How do you approach giving bad news to patients?
“I make sure I have time. You don’t want to rush people. You want to sit down, spend time, and answer all their questions. Try to sit relatively close to them and just go over the news you have to tell them. With a prostate cancer biopsy, I actually make them all come in and I set time aside because it can take a good 45 minutes to go over all the options after a positive biopsy.
I bring them back a week or two after giving them time to digest the information. I give them places where they can look through resources and bring them back to have the same discussion again. This time they’re more informed because they’ve heard the word ‘cancer’ and that’s all they’re focused on.
That way they can be comfortable with any decisions they have to make. The more comfortable they are with the process, the more comfortable with the outcome.
Don’t sugar-coat it, but don’t be too blunt. Be honest and forthright but try to do it as compassionately as possible. I’ll say, ‘let me go over the biopsy results with you. This is what we found.’ Let them know you have a plan for them.
The first time we talk it might be a generalized plan, but they have an option. Even if it’s patients with widely metastatic disease who are likely to be terminal, you can still offer them some sort of plan that is a way forward, so it gives them some hope.”
Carl Reese, MD