Do advanced non-melanoma skin cancer patients need to see a specialist? Dr. Sunandana Chandra explains the benefits of working with a specialist, how she empowers patients, and when she recommends seeking a second opinion.
Dr. Sunandana Chandra is a medical oncologist and Associate Professor of Medicine at Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Learn more about Dr. Chandra.
Why is it important that patients speak up and have a voice in their care?
Well, I think for person to feel empowered, they have to understand their cancer, in my opinion.
And that’s part of my responsibility is to try to share what I know about their cancer, my medical and clinical experience dealing with that type of cancer, and really, to try to empower them by giving them knowledge about their cancer, about their diagnosis, about the prognosis, about potential treatment options. And, I really think that that knowledge is really empowering for our patients and their family members, and I think with that knowledge, they can make the most informed decision, and they can help us then figure out what the best management plan for them is. You know, I try to spend a considerable amount of time with my patients and their family members and loved ones to explain all of this at the get-go so that that way, oftentimes, they can go home, they can kind of think about it, come back with more questions.
Or, if they do some additional research on their own, hopefully some of what I’ve talked about might resonate and might even spur on more questions that usually can be very helpful for us to try to answer, helpful for the patient, I mean.
Absolutely. Should patients consider seeing an advanced non-melanoma skin cancer specialist?
You know, for a “routine” non-melanoma skin cancer of which the most common are basal cell carcinomas, squamous cell carcinomas, they may be tiny spots, maybe one, potentially multiple, that can just be excised and the person can be followed closely. For them, perhaps seeing someone locally, maybe very reasonable.
But, if the patient themselves is ever worried or unsure, or they feel like they want to see a specialist, I absolutely would encourage that. In addition, for a person who has recurrent non-melanoma skin cancers, you know, multiple occurrences, maybe even more advanced than others, I think that those particular patients going to a specialist or a number of specialists may really help with the most advanced care. Maybe it’ll allow the patient and their team to be more proactive, maybe allow for other options that are maybe not standards of care, maybe novel, but promising.
And so, I think for patients who are worried or for patients with more high-risk features, more increased number of skin cancers, perhaps more advanced skin cancers, I think having an expert or a team of experts on their team is certainly worth considering.
What is your advice for patients who may feel like they’re hurting your feelings by seeking a specialist or a second opinion? Any advice for self-advocacy?
Oh, gosh. I mean, I always tell our patients I strongly encourage it if they bring up especially. You know, I never want to patient of mine or their family members to look back and have any regrets. And so, from the get-go, I think that they should seek opinions. They should feel comfortable with the management that I or someone else is recommending to them.
And, if a person asks me if it’s okay if they seek an opinion, I’m actually very encouraging of it because it doesn’t hurt my feelings. In fact, I think, again, it empowers the patient, which at the end of the day I think is most important and allows, hopefully, for them to have no regrets. And, I always tell patients more heads are better than one. So, if a colleague has another idea that perhaps I didn’t think of or vice versa, having that discussion and ultimately, that may allow for better patient care, which I think is all of our goals, which is actually our ultimate goal, I should say.