How Do I Overcome Real-Life Barriers to Lung Cancer Treatment?

Deandre White:

So, Dr. Florez, a big part of your research highlights how real life and structural barriers can disrupt lung cancer care, especially in marginalized communities. So what steps can patients take early in their diagnosis to make sure they’re receiving care that is supportive, respectful in their environment, and that understands their needs?

Dr. Narjust Florez:

I think very important is communication. It is very hard for a doctor, a nurse, or any type of healthcare provider to guess what patients want. So, I specialize in young patients with lung cancer. That means they do not like phone calls. A lot of my young patients don’t like phone calls. They like, they prefer text, they prefer messages. So, a way to get appropriate care is to ask, for example, what is your preferred way of communication? Because communication is a very big barrier for cancer care.

How we communicate, how we misunderstand. And I think now where patients have an easy access to results, is very important that you have that communication with your doctor, that, yeah, I’m going to look at the results, but I want a way to have a conversation. Because having access to CT scans, often, you know, generates anxiety. My father is a surgeon, he got his scans before he met the doctor, and he was hypothesizing, and I’m like, you are a urologist. This is very different than your neighborhood, and that’s my father, who’s a doctor.

So, the preference of communication, and also, I like my patients to bring to the clinic: How is the daily life? Because this is four walls in the clinic. And often, no windows. So, I see them for this small period of time. And I want to see what is the life?

So, creating this real life. Barriers are important. So what is a real-life barrier? A real life barrier is that you don’t feel comfortable driving in the city, right? That is something that unless somebody really asked, you won’t find out. So you can say, I don’t feel comfortable driving in the city. Another life barrier is, I have childcare needs. So, I prefer my appointments to be very early or be very late, right? Because we have also elderly. I’m the caregiver of my father, so I have to care for my father, so I have to do this.

So, bringing to the clinic what is your real life will allow the team to adapt to it. And one important thing, all sides, all seriousness, it is okay to take vacations. It is okay to postpone treatment for two to three days to go to Disney with your kids.

It is okay to go and take that cruise with your husband, or it’s okay to just take a break off. And that is okay. You have the power, it’s your health. It is okay to say, I’m going to move my treatment because my daughter is getting married and I don’t want those side effects. We have to give our patients the power back that the healthcare system has taken away from them. They are the owners of their health, and we’re here for guidance. I’m not here to be a dictator, I’m here for guidance. As long as reasonable, of course, and if it’s not reasonable, we’re going to talk about it. But I know I’m not going to give you a chemo the day before your daughter’s wedding.

No, get your daughter married, and then we start chemo a few days later. Overall, that won’t change the outcome, but you will feel good, and you will be able to do, you know, the Sweet Caroline that everybody does here in weddings. Reference to Boston. So, I think giving power, you have power to all of the patients that may be listening.

You have power. But the key to this power is to have a dialogue with your doctor, and if your doctor disagrees, let’s talk why. Not like, oh no, you say no. Because sometimes understanding allows for flexibility.