Reflections of an oncologist navigating imperfections in cancer care

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Reflections of an oncologist navigating imperfections in cancer care

Friday, 17 May 2024 | Prashant Mehta

Reflections of an oncologist navigating imperfections in cancer care

Doctors aren’t infallible gods but compassionate humans dedicated to easing human suffering, even in the face of formidable medical challenges

As an Oncologist, my days are filled with facing the most dreaded and life-threatening cancers head-on, armed with an arsenal of anti-cancer treatments that range from mild to equally dreadful. But amidst the battle against this relentless disease, I’ve come to understand that medical science is far from perfect.

Every time I sit down with a patient and their family to discuss treatment options, I embark on a delicate balancing act. Yes, I outline the potential benefits of the treatment, but I also dedicate ample time to explaining its imperfections and the associated risks - risks that can sometimes be massive, impacting not only the patient’s life but also their quality of life.

These discussions are rarely brief; on average, I find myself engaging with 2 to 8 family members, ensuring that everyone understands the complexities involved. And in these conversations, I make it a point to acknowledge that success is not guaranteed. I’ve had my fair share of failures and I recognise that my clinical judgments aren’t infallible.

In the realm of oncology, the weight of responsibility is immense. The human toll of the disease, coupled with the emotional turmoil experienced by families, weighs heavily on me every single day. There are moments when the sheer gravity of it all threatens to overwhelm me, but I gather my strength, reminding myself of the dignity, composure and compassion required to navigate through these turbulent waters.

Recently, I stumbled upon an opinion piece penned by Mr. CY Gopinath, recounting the journey of a patient grappling with suspected pancreatic cancer. The patient felt as though his oncologist was pushing a cancer diagnosis onto him. Such situations are not uncommon, especially when dealing with cancers that are notoriously difficult to biopsy. Misdiagnoses and the fear of missing a fatal diagnosis loom large in the minds of oncologists.

The widening trust gap between patients and healthcare providers is a cause for concern. Patients and their families may perceive our actions and recommendations in various ways, sometimes attributing them to ulterior motives. But the reality is often far more nuanced than it appears.

Having worked extensively in both private and Government healthcare settings, I’ve witnessed my fair share of diagnostic and therapeutic errors. These errors stem from the inherent imperfections of medicine and the challenges of navigating a complex healthcare landscape.

In the modern era, doctors are acutely aware of the trust deficit that exists between us and our patients. The notion of a ‘God complex’ is a myth; instead, we recognise our limitations and strive to bridge the gap through open communication and transparency.

While drugs and surgeries aren’t panaceas, alternative treatments aren’t always the answer either. It’s imperative to base our decisions on evidence-backed practices rather than succumbing to anecdotal allure.

In the realm of healthcare, there’s no one-size-fits-all solution. Each patient’s journey is unique, shaped by their individual preferences and circumstances. As doctors, we must personalise our approach, empowering patients to be active participants in their healing process.

It’s crucial to foster an environment where patients feel empowered to question, learn and seek second opinions. After all, informed decision-making is the cornerstone of effective healthcare delivery. In conclusion, amidst the cacophony of controversy and misinformation, the voice of expertise must prevail. Medicine is a science guided by evidence, not conjecture. Despite the challenges and uncertainties that lie ahead, I remain steadfast in my commitment to serve, echoing the words of my mentor: “Someone has to do this work and you’ve been chosen. Do it well.”

(The writer is a Senior Consultant and Program Director ( Lymphoid Neoplasms and Cellular therapy ) Department of Medical Oncology Amrita Institute of Medical sciences, Faridabad. Views are personal.)

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