3 SIMPLE THINGS TO IMPROVE CANCER CARE

Speaking as an old hand, O'Riordan summarizes her skill: "I thought I was good at telling people they had cancer."
She now knows she was mostly mistaken: "…until you have been on the other side of the table, you have absolutely no idea what impact your words have."
O'Riordan sees a common blunder of hers: "I used to tell women with small cancers that they were 'lucky' we caught it early. No one is lucky to have cancer."
She recalls the moment when she had just learned she had cancer.
"Like most patients all over the world, I had to do the 'walk of shame' past everyone else waiting to be seen, down long hospital corridors, desperately swallowing to stop myself from screaming and shouting and swearing," she reveals.
This brings O'Riordan to Simple Thing #1: "Signpost" patients to safe, accurate, and friendly information.
"Recommend useful books, websites, forums and apps that they can browse with their loved ones and get the support they don't yet know they need when they walk out of the hospital," she writes.
If this sounds onerous, it's not, O'Riordan says.
"Ask your current patients to give you a list of the sites they found helpful. Trust me, we've already done the hard work for you," she explains.
O'Riordan emphasizes the difference between having knowledge about cancer and having experience of cancer.
She needed radiotherapy (a process she had never even seen despite referring many patients), followed by tamoxifen tablets.
"I used to gloss over the menopausal side effects, saying that 'most women find they settle within 6 months or so.' Who was I kidding? The menopause was horrific — it happened overnight," O'Riordan reveals. She turned to a website for young mothers with cancer, and other patients for help.

Simple Thing #2

"Second, make sure that every patient knows what the symptoms and signs of recurrence are, and what to do when they are worried," writes O'Riordan. Again, this involves providing patients with information — once the initial treatment has ended. It also should be reviewed at every follow-up. "So many patients don't realize that cancer can come back years later," writes O'Riordan.
"Patients have to deal with the daily worry of recurrence," she says, adding that information can help.  Further, she believes in introducing patients to the concept of "scanxiety" — mental anguish that commonly occurs while waiting for follow-up imaging results.

Simple Thing #3

There's more to life after treatment than yearly scans, says O'Riordan, as a person living with cancer. But as a cancer surgeon, she acknowledged that she "never really thought about [patients'] returning to work, exercising to reduce the risk of a recurrence, or sex."
That's Simple Thing #3: empower patients to start living again — by addressing these issues.
"Thanks to the menopausal side effects of the drugs patients take for up to 10 years, the loss of libido, vaginal dryness, and painful sex that can wreck relationships and ruin lives. Especially if you are young and single," O'Riordan writes.
Her former self "never talked about sex after breast cancer with my patients," she admits. "I didn't think it was my job to." She now believes it is a physician's responsibility, if possible.
Anxiety, depression and posttraumatic stress disorder (PSTD) can occur months or even years later "when the reality of what you've been through, what you look like, and what might happen in the future starts to sink in," O'Riordan also points out, advocating for awareness.
Make the extra effort — it's not exhausting, O'Riordan says. "It's actually really easy to improve cancer care, and often it's the little things that can make the biggest difference. You just have to ask the experts — the patients themselves."