Her Diagnosis Made Her Faint!
“We have your results from your biopsy. The spot on your nose did come back as skin cancer. It’s a basal cell carcinoma. You will need to have additional treatment to.... are you alright?”
Fears about radiation therapy
The patient fainted in the exam room after learning she had a basal cell carcinoma on her nose. Once she regained her composure and was ready to continue, she immediately began crying. She explained that her brother had skin cancer on his nose years earlier and had a large portion of his nose removed and an equally large skin graft from his forehead. She was horrified that she might have to face the same fate as him.
Considering superficial radiation therapy as a treatment option
“I understand your concerns, and we do offer an alternative approach to surgery. It is called SRT, or superficial radiation therapy.” She started sobbing even harder. She then told us about how her best friend had breast cancer, and she watched her do radiation therapy and how difficult it was for her. She didn’t want to be burned and exhausted. "Again, I understand your concerns, but this type of radiation is different from what your friend experienced. For you, I do recommend SRT, so let us have you talk with our radiation therapist, and she can go over everything with you.”
Every patient is different
As the radiation therapist, I consult with most patients about their potential course of radiation therapy. Sometimes it is simple: the patient has faith in their board-certified dermatologist, and if that’s the recommended treatment, that’s the treatment they will do. Other patients have a difficult time, which is normal! They are given a cancer diagnosis and then bounced around from one provider to the next: big words, medical terms, and many appointments. I always try to build a professional relationship with patients when I first meet them and then connect personally. Sometimes that just is not the right approach.
Dispelling misconceptions about cancer treatment
When she stepped into my room, she was upset. She needed an advocate, not just another medical provider. I sat with her, and we talked and talked. She had misconceptions of what would happen to her now that she had skin cancer, which was completely understandable. It is scary and unfamiliar territory. I took the time to answer every question she had and made sure she knew she could always ask more if something else came to her mind. I showed her how I would position the shielding; how it would protect the rest of her body and only a tiny area on her nose would get any radiation. I demonstrated how I would set up the machine and that even though I would have to leave the room for her treatment, there is an intercom system, so she would never truly be alone. I worked with her schedule to make sure the appointments would work for her. I reminded her that her dermatologist is just a few steps away if there were any concerns during her treatment.
Nervous for treatment
She decided to go ahead with the SRT treatments. The first day she came in for treatment, she was still very nervous. She said she had not slept the night before. She was afraid of how the actual treatment would be. I walked her through setting up for her treatment. I got everything in place and shielded and reminded her that I could see and hear her if she needed me. I stepped outside the room and closed the door. I could see her feet tapping anxiously on the video monitor.
A massive wave of relief
The treatment started, and 30 pain-free seconds later, I opened the door, and her only words were, “NO WAY!” We both laughed, and she started crying again, but this time was different. She was so happy, and a massive wave of relief came across her. Everything she had worked up in her head was gone in a 30-second treatment.
Easy and painless
Twice a week, she came to see me. As her radiation dose built up, she did get some redness, like a sunburn-type reaction. We had discussed this, and she was prepared for it. Most importantly, she knew the side effects were only temporary. By her final treatment, she had an entirely different attitude. She no longer had fears about radiation therapy. She was sitting in the waiting room telling other patients how easy and painless the treatment is and how they have nothing to fear. Sometimes, not understanding is the scariest part.
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