Biological therapies for cancer in young people
Biological therapies use substances that your body naturally makes to destroy cancer cells. There are several different types of biological therapies, but the main ones...
“A doctor that knows how to talk to a young person is one that uses easy to understand language and simpler explanations without patronising them” – Interview 24
Although it is very difficult for young people who have developed cancer to come to terms with their illness – they can be enormously helped by health professionals who are sympathetic about their fears and anxieties, and who can explain what is going to happen, clearly and easily.
In the interviews, it is interesting that young people rate the communication skills of their doctor just as highly as they do their actual technical ability to treat them. What makes a good doctor is someone that talks directly to them rather than communicating through their parents. It is also important that they treat and respect patients as young adults rather than as children. A good doctor is also someone who is relaxed, friendly and approachable, listens to concerns, is willing to answer questions, and who can put a patient at their ease and provide reassurance.
One young man who was interviewed said that being able to share a joke with his doctor made him feel more supported (Interview 09). Most young people valued both honesty and straight-talking from their doctors about their prognosis, treatments, and the risks involved in the treatment procedures. Vital was the doctor’s ability to do away with medical jargon and explain things in simple terms. The mother of one girl was surprised and pleased to discover that the consultant explained things to her daughter in a much more straightforward way than he had explained it to her. Further, some said that their doctors often explained things to them over and over again in order to make sure that they fully understood what was going to happen. Others much appreciated being given information a bit at a time so that they could take it gradually which helped them come to terms with it all.
Not surprisingly, not all the young people we interviewed had entirely positive experiences. A few complained that their consultants had been insensitive or even patronising. One said that they felt that their doctor was just treating their illness but not them as a person. A few felt unhappy with their consultants and asked to be treated by someone else. One said that their first consultant found it difficult to ‘share’ the care of their patients with other colleagues who needed to be involved. Another was horrified to find out, only three hours before his operation, that he was going to have one of his testicles removed.
Many young people found that their doctors and nurses provided all the information they needed and were always happy to answer their questions. Others thought that their consultant’s approach was to try and not unnecessarily overload them with information. But this wasn’t always the case and, one young person (Interview 22) said that her doctor seemed so incredibly busy, that she was put off asking the questions that were important to her but which the doctor might think were minor. A few young people thought that obtaining information that they wanted about their cancer had been difficult because their particular case was very unusual and therefore their doctor had not dealt with it before.
Most young people found it helpful to have a parent with them when seeing the doctor because parents could then ask the questions that the young people might not have thought to ask themselves. One mother said that she would have liked the doctors to talk to her more so as to advise and reassure her, so that she could then, in turn, reassure her son (Interview 05) (see also ‘Finding good information and good information sources‘).
Junior doctors in hospital were sometimes the subject to criticism because of their relative lack of expertise and inexperience at disclosing information to young people and their parents. One mother described how a junior doctor had given misleading information, causing her unnecessary fears and anxiety.
In almost all aspects of care young people found nurses an enormous support and praised their sensitivity, compassion, friendliness and sense of humour. Nurses were also less formal than doctors and hence were more approachable and better at explaining things in a fun and easily understandable way. Part of this was that many nurses were closer to their patient’s age so they can talk about ‘stuff’ which is pertinent to that age group, for example, about music or school life (Interview 07) (see ‘Being in hospital‘).
Another important issue was continuity of care. While some young people had seen the same consultant since they were first diagnosed others said that they didn’t always see the same doctor, and that this lack of continuity made it harder to develop good rapport and trust between them and the doctor. While many consultants were described as ‘inspiring confidence’, it is not always the case that young people felt able to open up and talk to them about their worries and/or innermost feelings.
It was certainly the case that overall the young people we spoke to were full of praise for their doctors – describing them as ‘brilliant’, ‘wonderful’, or ‘amazing’. Many said that they felt forever grateful to them and to all the health professionals who had looked after them, and couldn’t thank them enough. Some people in their twenties had been treated by both paediatric and adult cancer specialists and found them equally good at supporting and helping them. Young people when praising the care that they had received on the NHS said that they doubted that private medicine could do better.
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