Guest Columnist Dr. Roy Sessions – The Journey from the Referring Doctor to the Oncologist: An Anxious Time

RoySessionsPhysicians and dentists generally send those patients with suspected or confirmed cancer to oncologists*. Referrers can be primary care doctors, gynecologists, endocrinologists, pulmonologists, gastroenterologists, otolaryngologists, dermatologists and others. Not uncommonly, at the time of the initial visit with a surgeon or one of the other oncologists, the patient is unclear as to whether they have a malignancy. Many of them have been told, but they did not hear what they didn’t want to hear. This reflects something I wrote in an earlier blog – the brain is an effective filtration system for frightening information.

In situations in which there is suspicion but no proof of cancer, the referring doctor may have told the patient, “You have a problem,” or “You have a tumor,” or “You have a growth,” but often the realistic possibility remains unclear or even has been denied in the patient’s mind; and let’s not forget (this should not come as a surprise) that many doctors seek to avoid delivering bad news. While that might seem like an abdication of one’s responsibility, it’s actually correct for them to skirt around the cancer or malignancy words until proof is actually established. In most patients, the use of slightly evasive terms such as “a problem, a tumor, a growth” is enough, unless for some reason, the next step of arranging for an oncologist is inordinately delayed, in which case it is more difficult to be vague. However, even if such is not the case, the patient will sometimes push the referring physician to speculate – this tricky conversation should be avoided! If the patient asks directly, “Could it be malignant?” the physician should be honest with a simple yes—after all, why else would the patient be referred to a cancer specialist? The physician’s mere concern raises the patient’s anxiety level, and it is generally wise for the referring doctors not to speculate on likelihood or other specifics. One is tempted to comfort such a patient, but on many occasions, the attempt introduces unrealistic expectations or conversely, greater anxiety. In certain circumstances, however, it is appropriate for the physician to offer general data that is favorable and that might give a patient cause for hope during this interim period. For example, approximately 80 percent of “incidentally” discovered breast masses in women turn out to be nonmalignant. This is a widely known fact, but a well – timed emphasis on it can be emotionally helpful to a frightened woman. Similar optimism is possible in a patient with a parotid (salivary) gland tumor, in which about 75 percent are benign. Quoting such generic data when sending the patient for a diagnostic procedure or to an oncologist is different from specifically making predictions about that particular patient’s mass. In the case of a potentially ominous tumor—a pancreas mass for instance— no real value is gained by quoting such generic data i.e. the dismal statistics associated with this particular tumor. In many cancers, the probability of cure is directly related to stage (degree of advancement), and in the process of quoting statistics, the bad as well as the good has been included in the calculus – that too should be considered in the attempt to help with generic data. All things considered, better the patient be properly worked up and staged before the prognosis is bantered about. Then, and only then, is it wise to discuss real data and specific outcomes i.e. prognosis.

Continue reading “Guest Columnist Dr. Roy Sessions – The Journey from the Referring Doctor to the Oncologist: An Anxious Time”

In The News-Bob Mason AKA “Doctor Geezer”

Be sure to watch SCETV’s Palmetto Scene program on Thursday, September 25th and Sunday, September 28th.  The program will highlight Seabrooker, Bob Mason, AKA “Doctor Geezer” at Roper St. Francis and MUSC Children’s Hospital and his endearing impact on patients, young & old!

Submitted by Tidelines Editor

Parking on Seabrook Island Roads

A gentle reminder brought to you by the SIPOA Safety and Security Committee.

Rules and Regulations Governing Parking on
Seabrook Island Roads

The purpose of this article is to clarify the parking rules on Seabrook Island roads.

Parking is permitted on the road and the grass portion of the right-of-way in front of unimproved lots.

Parking on the grass in front of improved lots is allowed only with the property owners’ permission. Otherwise the vehicle must have all four tires on the road.

To the extent practicable, parked vehicles are to be facing the direction of travel and on one side of the road.

No parking is allowed within 50 feet of all traffic islands and fire hydrants. No permanent street parking on the streets of Seabrook Island.

And as to whether or not you should park, ask yourself “Can an emergency vehicle get through?”

If further clarification is needed, please go to:
The sipoa.org website, under the ‘Library’ tab, click on ‘Rules and Regulations’. Go down the document tree to “Government Documents” and click on the ‘SIPOA Rules and Regulations’ document, page 9, section 6.

-Submitted by the Safety and Security Committee

Guest Columnist Dr. Roy Sessions: Quality of Life Concerns and The Search for Autonomy in Cancer Patients

This is the fourth in a series of columns on the doctor/cancer patient relationship by Seabrook resident Dr. Roy Sessions, MD, and Fellow of the American Council of Surgeons. 

RoySessionsThe days in which patients rarely challenged medical recommendations are long past, and an informed patient – even one with cancer – frequently seeks input into the decision process about therapy options.  The paternalism of the past, in which a doctor’s advice was sacrosanct and unchallengeable, has appropriately been replaced with an inclusive approach in which the patient is offered choices – specific advice, of course – but choices nevertheless.

This new attitude comes out of the information age in which there is little proprietary knowledge, and importantly represents a search for autonomy in many informed patients. Truth be known, this new attitude is not only directed to the medical profession, but applies to the questioning of most authority figures – the law, the clergy, the modern family unit and others.  For better or worse, blind acceptance of dogma is not the norm in 2014.   Let’s explore this notion as it pertains to the management of cancer patients. Continue reading “Guest Columnist Dr. Roy Sessions: Quality of Life Concerns and The Search for Autonomy in Cancer Patients”

Amenities Flyover Video Now on Vimeo

For those who missed our original post on July 19th, here is a re-post of the new Seabrook Island Amenities flyover video recently taken by camera drones.

It’s been uploaded to the popular video sharing website Vimeo and resides at the following address: vimeo.com/99255923. This facilitates easy forwarding to friends and other interested parties, and allows the video to be embedded as below in blogs and other social media sites that support Vimeo embedding.

 

—Tidelines Editor

 

Guest Columnist Roy Sessions, MD: The Importance of Physician Beneficence

RoySessionsDiscussions of beneficence have historically been sparse in the medical, and even the cancer-specific literature. However, because of shifting societal attitudes, especially as they apply to the practice of medicine, important basic changes have occurred that qualify this fact. Emphasis on patient education, their rights, their autonomy and the encouragement of self-advocacy have become the new norm, and despite a continued deficiency in the relevant literature, the very concept of beneficence has become essential to contemporary medical dialogue and thinking.

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Guest Columnist Roy Sessions, MD: The Relationship of Trust to Hope in Cancer Patients

RoySessions

In my June blog, “The Redefinition of Hope,” I promoted a more flexible characterization of hope among cancer patients by contending that goals less ambitious than actual cure ought to be part of the new vocabulary. Time for closure in life, restating affections, mending friendships, a tranquil death, and other desirables were cited as examples of this new vocabulary. I went on to state that trust between cancer patients and oncologists was essential to the development of hope, whatever its definition. Let’s explore the linkage.

Continue reading “Guest Columnist Roy Sessions, MD: The Relationship of Trust to Hope in Cancer Patients”

How to Become an Art Collector: It’s Easier Than You Think–Part 5

[This is the last of a five-part series by Seabrooker Barbara Burgess. The first four included “Getting to Know the Artists”, “Developing a Theme”, “Training Your Eye”, and “Considering Your Pocketbook”.–Ed.]

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Gift or Sell Your Collection

The notion of gifting or selling your collection to a museum is probably not one that you thought about while putting your art together, but it is something that should be considered for many reasons. First, keeping your collection together is important, because in this case, the sum is likely equal to more than the collective parts. Should anything happen to you, your heirs would face the choice of keeping the collection together or splitting it up in various pieces for family members. You’ve built a story out of your art, which needs to be shared by others. It is much easier to do this from the walls of a museum than from the walls of your house.

Continue reading “How to Become an Art Collector: It’s Easier Than You Think–Part 5”