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How to talk with your doctor                              Suzana Makowski, MD MMM FACP                        Associate Di...
Why talk about this?        Helps you get the best care possible:            your disease and treatment            your wi...
Things to considerFriday, March 16, 12
Things to consider                       How much do you want to know?Friday, March 16, 12
Things to consider                       How much do you want to know?                         Everything? Nothing?Friday,...
Things to consider                       How much do you want to know?                          Everything? Nothing?      ...
Things to consider                       How much do you want to know?                          Everything? Nothing?      ...
Things to consider                       How much do you want to know?                          Everything? Nothing?      ...
TopicsFriday, March 16, 12
TopicsFriday, March 16, 12
Diagnosis and Treatment                       What do I need to know about my disease?Friday, March 16, 12
Diagnosis and Treatment                       What treatment options do I have?                        Risks and benefits  ...
Diagnosis and Treatment                       What treatment options do I have?                        Risks and benefits  ...
Diagnosis and Treatment                       What other treatment options do II have?                             What tr...
Diagnosis and Treatment                       What other treatment options do II have?                             What tr...
Diagnosis and TreatmentFriday, March 16, 12
Diagnosis and Treatment                       How will treatment affect the things that                       are importan...
Dx/Tx to SxpsFriday, March 16, 12
Dx/Tx to SxpsFriday, March 16, 12
Symptoms and side effectsFriday, March 16, 12
Symptoms and side effects                       Knowing your symptoms and side effects                       gives doctors...
Symptoms and side effects                       Knowing your symptoms and side effects                       gives doctors...
Symptoms and side effects                       Knowing your symptoms and side effects                       gives doctors...
Symptoms and side effects                       “I get so nervous”Friday, March 16, 12
Symptoms and side effectsFriday, March 16, 12
Symptoms and side effects                       “I don’t want to be a complainer”Friday, March 16, 12
Symptoms and side effectsFriday, March 16, 12
Symptoms and side effects                       “I thought my doctor                           already knew “Friday, March...
Symptoms and side effectsFriday, March 16, 12
Symptoms and side effects                       “I can’t afford another                               medicine”Friday, Mar...
Symptoms and side effectsFriday, March 16, 12
Symptoms and side effects                       “””I have cancer, I’m supposed to                                feel this...
Symptoms and side effectsFriday, March 16, 12
Symptoms and side effects                        • Tell doctor or your nurse                        • Write down your symp...
Symptoms and side effects                       Knowing your symptoms and side effects                       gives doctors...
TopicsFriday, March 16, 12
TopicsFriday, March 16, 12
Friday, March 16, 12
Prognosis                       • Talking about prognosis does not change                         the prognosis           ...
End-of-life                       Where do you want to be?                       How do you want to be                    ...
Elephant to HopeFriday, March 16, 12
Elephant to HopeFriday, March 16, 12
Goals of care                       What’s important to me?                       What am I fighting for?                  ...
Finding hope:                           good communication means:                       Partnership: doctor-patient       ...
Thank youFriday, March 16, 12
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How to speak with your doctor (when you have cancer...)

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I gave this presentation at a community symposium for people affected by pancreatic cancer.

Published in: Health & Medicine
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How to speak with your doctor (when you have cancer...)

  1. 1. How to talk with your doctor Suzana Makowski, MD MMM FACP Associate Director of Palliative Care in the Cancer Center Assistant Professor of Medicine UMass Memorial Medical CenterFriday, March 16, 12
  2. 2. Why talk about this? Helps you get the best care possible: your disease and treatment your wishes and values your hopes and fears your symptoms and side effects what’s most importantFriday, March 16, 12
  3. 3. Things to considerFriday, March 16, 12
  4. 4. Things to consider How much do you want to know?Friday, March 16, 12
  5. 5. Things to consider How much do you want to know? Everything? Nothing?Friday, March 16, 12
  6. 6. Things to consider How much do you want to know? Everything? Nothing? Who else should know?Friday, March 16, 12
  7. 7. Things to consider How much do you want to know? Everything? Nothing? Who else should know? What should my doctor know about me?Friday, March 16, 12
  8. 8. Things to consider How much do you want to know? Everything? Nothing? Who else should know? What should my doctor know about me? Consider bringing a notebook/folder, or an organized & trusted friend to record notes & questionsFriday, March 16, 12
  9. 9. TopicsFriday, March 16, 12
  10. 10. TopicsFriday, March 16, 12
  11. 11. Diagnosis and Treatment What do I need to know about my disease?Friday, March 16, 12
  12. 12. Diagnosis and Treatment What treatment options do I have? Risks and benefits Side effects How should I feel?Friday, March 16, 12
  13. 13. Diagnosis and Treatment What treatment options do I have? Risks and benefits Side effects How should I feel?Friday, March 16, 12
  14. 14. Diagnosis and Treatment What other treatment options do II have? What treatment options do have? Risks and benefits Side effects How should I feel?Friday, March 16, 12
  15. 15. Diagnosis and Treatment What other treatment options do II have? What treatment options do have? Risks and benefits Side effects How should I feel?Friday, March 16, 12
  16. 16. Diagnosis and TreatmentFriday, March 16, 12
  17. 17. Diagnosis and Treatment How will treatment affect the things that are important to me?Friday, March 16, 12
  18. 18. Dx/Tx to SxpsFriday, March 16, 12
  19. 19. Dx/Tx to SxpsFriday, March 16, 12
  20. 20. Symptoms and side effectsFriday, March 16, 12
  21. 21. Symptoms and side effects Knowing your symptoms and side effects gives doctors clues on how best to care for you.Friday, March 16, 12
  22. 22. Symptoms and side effects Knowing your symptoms and side effects gives doctors clues on how best to care for you. Untreated symptoms or side effects can drain you physically and emotionally.Friday, March 16, 12
  23. 23. Symptoms and side effects Knowing your symptoms and side effects gives doctors clues on how best to care for you. Untreated symptoms or side effects can drain you physically and emotionally. The only way we know is if you tell us.Friday, March 16, 12
  24. 24. Symptoms and side effects “I get so nervous”Friday, March 16, 12
  25. 25. Symptoms and side effectsFriday, March 16, 12
  26. 26. Symptoms and side effects “I don’t want to be a complainer”Friday, March 16, 12
  27. 27. Symptoms and side effectsFriday, March 16, 12
  28. 28. Symptoms and side effects “I thought my doctor already knew “Friday, March 16, 12
  29. 29. Symptoms and side effectsFriday, March 16, 12
  30. 30. Symptoms and side effects “I can’t afford another medicine”Friday, March 16, 12
  31. 31. Symptoms and side effectsFriday, March 16, 12
  32. 32. Symptoms and side effects “””I have cancer, I’m supposed to feel this way.”Friday, March 16, 12
  33. 33. Symptoms and side effectsFriday, March 16, 12
  34. 34. Symptoms and side effects • Tell doctor or your nurse • Write down your symptoms • Bring a friend or family member What kind of symptom? • pain • nausea • breathlessness • anxiety • thinking How bad is it? • mild • moderate • severe Where is it? Timing? • constant • worse in morning/night • intermittent What makes it better? What makes it worse? How does it effect your life, activities?Friday, March 16, 12
  35. 35. Symptoms and side effects Knowing your symptoms and side effects gives doctors clues on how best to care for you. Untreated symptoms or side effects can drain you physically and emotionally. The only way we know is if you tell us.Friday, March 16, 12
  36. 36. TopicsFriday, March 16, 12
  37. 37. TopicsFriday, March 16, 12
  38. 38. Friday, March 16, 12
  39. 39. Prognosis • Talking about prognosis does not change the prognosis • Most doctors wait for patients to ask this question • Helps us plan - even when the prognosis is goodFriday, March 16, 12
  40. 40. End-of-life Where do you want to be? How do you want to be cared for? Who do you want with you? Who can best help advocate for you? Finding hopeFriday, March 16, 12
  41. 41. Elephant to HopeFriday, March 16, 12
  42. 42. Elephant to HopeFriday, March 16, 12
  43. 43. Goals of care What’s important to me? What am I fighting for? What are my goals and hopes?Friday, March 16, 12
  44. 44. Finding hope: good communication means: Partnership: doctor-patient Optimal treatment Personalized care Symptom control Dignity & integrityFriday, March 16, 12
  45. 45. Thank youFriday, March 16, 12

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