The diagnosis of cancer and its treatment creates enormous physical, emotional and spiritual vulnerability in the patient and her loved ones. None of us can predict how we will react to this extreme episode in life. Much of it will depend on your personality, stage in life, and strength of existing relationships with your partner and loved ones, and prior experience with the health system. For many, it will be your first stay in hospital. Therefore most women, and their carers, have no prior experience with the way to manage cancer, from diagnosis through treatment, to life after treatment. Most undoubtedly will have a view, often negative and fearful, that is developed from a range of sources including the media, but mostly from stories of others that have experienced cancer. Therefore your relationship with the cancer specialist and the treatment team is vital to maintaining some quality in your life, and progressing through your treatment with a level of confidence.
As good communication is essential to both the doctor and yourself in making sure your needs are fully met, it is important that you quickly develop some sort of rapport. How can this be established?
If the doctor is someone known from reputation or a recommendation, you immediately have prior knowledge of the doctor’s style and ability. This immediately instills a level of trust. For most, however, the doctor will be someone who is completely unknown to you, and rapport has to be developed from the first appointment. It is important that a sense of mutual trust be established. ‘Can you talk openly with your doctor?’ Without trust your recovery may be slowed by fear, uncertainty and confusion. Trust does not necessarily mean ‘like’. In the first visits when you are numbed by the diagnosis, you may not develop the instant rapport you had hoped. However, if you have trust in the specialist skills of the doctor, and he or she has a sound reputation, rapport most often quickly develops.
You may be like the ‘very assertive patient, who generally takes an ‘intellectual’ approach to her illness, who will question, make demands and have a great need to be in control of all decisions and management of her treatment. She may often take longer in the appointment and is usually able to clearly articulate all aspects of her treatment, using medical jargon, to doctor, friends and family. She will often seek current medical literature from global sources and be involved in specialist ‘chat rooms’. These women are often using complementary therapies as a daily routine, are high Internet users for sources of information and are aware of current cancer therapies. Building close rapport with the health team is usually not a priority as she sees herself as highly independent and in control.