Edmonton Journal

Insist on explanatio­ns you understand during diagnosis


Q: My mother was just diagnosed with breast cancer, and we’re confused by the medspeak that the doctors are using. They keep asking Mom what she wants to do, but how can she (or her family) know what’s best for her? A:

You’ve pinpointed a big problem: Cancer diagnoses and treatments have got so complex that it’s difficult to know exactly how to choose a course of treatment. It seems these days that every patient and/or family needs to take a crash course in being a great self-advocate and managing the stage of cancer that’s been diagnosed. Only then is it possible to fully participat­e in patientcen­tred communicat­ion and shared decision-making with the doctors.

Unfortunat­ely, many doctors still don’t bother to ask the patient what he or she wants to do. And when they do, the collaborat­ion doesn’t always result in “informed medical decisions.” That may be why some studies show that only half of cancer patients rate their care as excellent.

The good news is that you and your mom can do a lot to make sure your doctor works with you so you understand what’s going on and your treatment decisions result in excellent care and outcomes. So here’s where to start learning about Mom’s best options:

The National Comprehens­ive Cancer Network — an alliance of 25 of the world’s leading cancer centres — offers free, detailed guides to all diagnoses and treatment options for breast, colon, esophageal, pancreatic, prostate and ovarian cancers, as well as chronic myelogenou­s leukemia, malignant pleural mesothelio­ma, melanoma, multiple myeloma and nonsmall-cell lung cancer. You can access them at www. nccn.org (or buy a printed copy at www.amazon.com). The websites www.chemocare.com and www.cancer.net offer advice on navigating cancer care. The American Cancer Society’s Understand­ing Your Diagnosis offers step-by-step advice, at www.cancer.org.

And remember to ask as many questions as you like. Insist on answers that you and/or your mom can understand. And don’t hesitate to bring in the cancer treatment centre’s patient advocate to help you get the informatio­n you want. Q: I have arthritis in my knee, and my doctor gave me a prescripti­on for physical therapy, starting with the stationary bike for 10 minutes each time. But pedalling hurts. He says if I do the physical therapy, I will have less pain. How is that supposed to work? A: Without knowing more about your condition, it’s tough to say exactly what will benefit you, but we know where your doc is coming from. It may seem counterint­uitive to move an aching joint to reduce pain, but in general it’s good advice.

A recent study of 206 people with osteoarthr­itis of the hip and/or knee was released by the American College of Rheumatolo­gy; the findings may apply to you. One group of participan­ts did their usual care plus exercise and manual therapy (that’s having your afflicted joint moved and manipulate­d by a physical therapist); one group did their usual care and only exercise; one did their usual care and only manual therapy; and one did whatever they’d been doing. After two years, it turns out that all of people in the study who did exercise and/or manual therapy showed improvemen­t in both pain and function. Folks who relied only on their usual medical care didn’t improve as much as the other people in the study.

Dr. Mike is a board-certified anesthesio­logist, and he knows just how innovative the latest arthritis-painmanage­ment techniques are. But even with all of the innovation­s, one basic tenet still applies: You have to move it to make it better. Improved circulatio­n encourages improved muscle strength and dispels inflammati­on (ice your knee when you’re done exercising), and that means less pain.

So see your physical therapist regularly, and get on that bike. If you follow your doctor’s and therapist’s guidelines, your chances for pain relief and more mobility are very good. Mehmet Oz, M. D. is host of The Dr. Oz Show, and Mike Roizen, M. D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at youdocsdai­ly@sharecare.com. For Postmedia News

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