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Cervical Cancer

Talking to doctors

There is no easy way to tell someone that they have cancer. However, many people describe their cancer experience as life-changing and the way in which they are told can have a powerful impact on their state of mind, coping ability and future relationship with their medical team. 

Some women said they were glad they had been told their diagnosis in a straightforward manner. Others described the way their doctor had told them their diagnosis as blunt but in hindsight felt it was probably the best way to break the news. One woman wanted her doctor to be more direct with her. Many women were alone when they were told they had cancer.

 

She would have preferred her doctor to have told her her diagnosis in a straightforward manner.

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Age at interview: 37
Sex: Female
Age at diagnosis: 32
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He, I sat down, he started to carefully tippy-toe around the topic I think and he said that there were two, two types of cancer cells, one cancer cells with a line and pre-cancer cells and he said I was sort of around in the middle, he was trying to break the news in carefully I suppose. And I just said 'Well have I got cancer or have I not got cancer, I don't want this vagueness?' To which he said 'Yes, yes you have.' And then said you know did I have children because I probably wasn't going to have, probably I wasn't going to be able to have any more and that I needed to have a hysterectomy.

And when he told you your diagnosis, what was, would have been the best way for you?

Well I suppose it's a bit abrupt just to sit you down and say 'Yes you've got cancer,' but probably that way, rather than sort of making it sound something that it isn't. 

People react in different ways when they are told they have cancer. One woman described how, because she didn't react as he had expected when he gave her the result that her cancer was advanced, the consultant seemed to feel he had to keep repeating it until she showed the expected reaction.

 

She explains how she felt when her doctor did not realise that she had understood her diagnosis.

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Age at interview: 28
Sex: Female
Age at diagnosis: 27
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And he came round and sat on my beside and he said "Oh yes you're fine to go, fine to go." And then he obviously thought better of it, he sat back down, he said "Look," he said "you know this is very serious and you are probably going to have a hysterectomy or radiotherapy and chemotherapy." I said "Yeah I know." And he just kept going on and on and on and on just, I think it was the stage that you know people expect you to react a certain way when you're told you've got cancer and because I was sitting in bed you know reading a magazine waiting to be discharged you know he probably looked at me and thought oh I'm not sure whether or not she's actually taking this in because he thought that perhaps if he'd been told he had cancer then he'd be really distressed and crying. 

Which I was really upset about actually because I ended up being in such a state crying that I thought it was really out of order. Actually I think that was one of my negative things actually about my experience that I think doctors have got to be very careful about, about talking to patients about things like that. Because everybody deals with things very, very differently and just because somebody isn't crying doesn't mean that they haven't taken something in or absorbed it. I mean I'm not a stupid person, I am, you know I know people that have had cancer and I do understand a bit about it. So you know he rather upset me actuallly.

Communication between doctors and their patients can profoundly affect how patients cope with their illness. A woman who felt exceptionally well cared for describes the friendly and approachable manners of her medical team helped her to feel positive during her recovery in hospital. Another described feeling confident in her surgeon's judgment because he answered all her questions and gave her lots of information.

 

Her medical team's attitude helped her feel positive during her recovery in hospital.

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Age at interview: 53
Sex: Female
Age at diagnosis: 51
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But I felt very positive, I felt good about myself because they were telling me how well I was doing, that, may be they, they probably say that to everybody. As I say the medical team I think the whole way that they work together they know what's going on, they know, you feel that they know you and that they are being very you know friendly without being pushy but you know and that they know your case, they understand what's going on. You don't get somebody coming in leafing through your notes not knowing what's happening, they all know exactly where you are and what's happening and what stage you're at and all that sort of thing. 

In contrast, one woman describes how she felt about the insensitivity shown to her by a doctor at the cancer clinic. Another said her consultants had made personal comments to her had led her to feel uncomfortable at future appointments.

 

The insensitivity shown to her by a doctor on her first visit to the cancer clinic affected her...

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Age at interview: 47
Sex: Female
Age at diagnosis: 47
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 I left the hospital to go straight to this other clinic and I felt very strong in my mind, in my head, I was very positive and I'd felt I came out of my disappointment well, and I felt quite you know positive about right, this is gonna be dealt with a different way.

But what happened was the doctor came in, it wasn't the doctor who I'd been told I'd be seeing, my card said one name, this person had another name. It wasn't explained to me why that was um, I was asked to tell my story from the beginning and the doctor was interrupted twice with bleeper messages and without even saying 'Excuse me,' sort of took the messages, so just cut off my story as if it was not that important.

So I was very vulnerable but I think, when I was thinking about it afterwards I thought they should have been aware of that. They didn't seem to be aware that I'd just come out of one hospital straight into another. If I'd been coming from home and hadn't had surgery I would have been feeling a lot different I think and I probably would have said 'Do you mind! Are you gonna listen to this or not?' But as it was I was just oh, oh, sort of um, felt awful. So of course I just felt so resentful that this particular clinic had just wiped out probably a good week of work that another hospital had just done. 

I block it out of my mind because I think that was one bad experience that I took very kind of badly. If I was to tell that person they probably would see what, what I meant but probably its just such an everyday occurrence for them that it becomes numb to them so they probably just wouldn't have realised that, how I felt. Um, so I do try to keep it under control because I don't want that particular place to become a kind of a, a phobia you know because it can happen. Um, you know that sticks in my mind.
 

She felt that consultants should be able to be friendly but was made uncomfortable by personal...

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Age at interview: 37
Sex: Female
Age at diagnosis: 32
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Oh one other thing I guess, probably not just because it was cervical cancer, but because it was such a personal area two consultants made quite personal remarks about me which I remember at the time feel incredibly uncomfortable. Now they probably meant to just say them just to sort of make polite conversation but again because it's such an intimate part of the body and because you're feeling quite vulnerable at the time that had again quite, had a very, very uncomfortable feeling on me and I remember being very uncomfortable with that particular consultant afterwards when he had to check-up on me. So that again I would say if the consultant can just try and be as, almost objective and not de-humanised because it is lovely when they can smile and when they can you know add something of themselves. But I think particularly when you're a young female it's quite hard always having, because they're normally male consultants, it's quite hard having a comment on how you either look or what you're wearing or anything that. That I think they don't understand that it can actually make you feel quite uncomfortable.

Decision-making about treatment could be made easier or more difficult according to the manner of communication. One woman explains how the open communication between herself and her medical team had helped her to decide to have a trachelectomy (where the womb (uterus) is left in place so it’s still possible to have a baby).

 

Her decision to have a trachelectomy was helped by the positive communication with her medical team.

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Age at interview: 39
Sex: Female
Age at diagnosis: 31
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I think the team at the hospital I went to were all very supportive and openly communicative. We had open, honest discussions and I think that was really important because we all knew what, they knew what I felt, I knew what they wanted to do and how they felt. And we were just able to talk openly about everything, treatments, diagnosis, I could say what I wanted to the consultant but I felt he listened to me and took my views into consideration which doesn't always happen I know. But the whole team were really good, they worked together with you as part of the team really. So yeah I think that was really positive.

Many women said it had made a considerable difference when doctors or nurses explained procedures during tests and treatments. In comparison, one woman had experienced unnecessary distress because she had not been told why she needed to sign a form during her radiotherapy planning session.

 

She felt reassured by the way her doctor communicated with her.

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Age at interview: 53
Sex: Female
Age at diagnosis: 42
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He was always talking, telling me before what he was going to do to me and he was talking through and it was just his, for example he calls me "pet", probably he calls every woman who visits "pet", but he made me sort of feel a bit special to him. Which is, reasoning I know it's not but at the same time it's pleasant and then you're good, that everything is fine and don't worry. All these are sort of pleasant way of, which you know and as I say he was going to tell me before "Now I'm doing this. Oh I know it's a bit cold, it's a bit unpleasant. Yes it's going well." You know these sort of reassuring little words of chit chat which it's probably part of his routine and it's extremely pleasant and comforting and reassuring.
 

Not being given an explanation for why she needed to sign a form caused her unnecessary distress.

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Age at interview: 42
Sex: Female
Age at diagnosis: 36
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I've never experienced it with another doctor before, I've never seen it before. And to me it's one of the most biggest things that's ever happened in my life and for that doctor not to be able to have the time to show me what this yellow form was about and to see what I was signing was just diabolical I think. 

Because I think when you're having an operation you just say "Oh we're going to take this tooth out and you're signing for the anaesthetic," but er they couldn't be bothered. And I'm not just a piece of meat, I know people often say that expression with doctors and surgeons that they see you as just a lump of a body there, that they're going to do something to. But it's such a big massive important thing in my life that I didn't just want to just sign this yellow form. 

But I'd caused so much upset, I'd upset myself, I'd upset my husband, I'd upset my daughter because I wouldn't sign it. But you know I just felt I wasn't going to be bullied that afternoon by this doctor. When he was treating me wrong it was sort of, I suppose the upset and everything got hold of me, but I didn't actually tell him off or call his superior, I just refused to sign it and said I wanted to go home and started crying (laughs).

Communication between doctors and their patients can reduce or increase patient's concerns about ailments following treatment for cancer. Several women stressed that doctors should listen to and address these concerns and recognise that what may seem trivial to a doctor may create anxiety in the patient until it is fully explained.

 

She comments that doctors should address their patients fears about ailments following treatment...

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Age at interview: 37
Sex: Female
Age at diagnosis: 32
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I could definitely understand how consultants can get quite blas' about it and it's probably irritating to them. It's having these worries and having these concerns, you know they can see from, because they've got the bigger picture that they are just so small and they're trivial but when you're actually going through it it means so much and because you don't feel like you have control over the knowledge I think for me the most important would be to have somebody who always just made sure they've answered the fears. 

Rather than just say "Don't worry about it, its just one of those things cancer patients always worry about getting it again," for me it would be making sure, and making sure that they checked up on it. So if for example I didn't ever get an understanding of why the muscle had gone from above my belly button until I actually discovered two other women that had got exactly the same. And my understanding is it's where the muscles have come apart and there's a diverifaction. It's actually you know a side effect from having a baby. And I kept those worries inside for quite some time. 

So instead of the consultant just saying "Don't worry about it," I'd have liked for him to have double checked or just for him to just given me the peace of mind of going to a physiotherapist or somebody who would have an understanding of why that part of my body had changed because it would have meant quite a big difference to me for the next couple of years and I might not have kept back some of the information later on when I'd got pain. And who knows had that been something else that probably wouldn't have been a positive thing to do at all. 

So I think if consultants can sort of just be patient with the fact that I know they see the fear and they understand that they're probably very unnecessary fears it's definitely far better from the patient's perspective to have those fears answered and tested. Even if it is literally "Just let me double check, no that seems absolutely fine," would have been enough to reassure.
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Last reviewed July 2017.
Last updated April 2014.

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