Tag Archive for: counseling

How Are Common Breast Cancer Concerns Addressed?

How Are Common Breast Cancer Concerns Addressed? from Patient Empowerment Network on Vimeo.

How can common breast cancer concerns be addressed? Expert Dr. Bhuvaneswari Ramaswamy explains issues that can arise during a patient’s breast cancer journey and discusses how they can be managed.

Dr. Bhuvaneswari Ramaswamy is the Section Chief of Breast Medical Oncology and the Director of the Medical Oncology Fellowship Program in Breast Cancer at The Ohio State College of Medicine. Learn more about this expert here.

See More from Thrive Breast Cancer

Related Resources:

Thriving With Breast Cancer Tools for Navigating Care and Treatment

Why Should Breast Cancer Patients Feel Empowered to Speak Up About Their Care?

What Role Do Breast Cancer Patients Play in Care and Treatment Decisions?



When discussing cancer treatments with a patient, they have worries, obviously. What are some common concerns that patients typically have, and how do you counsel them?

Dr. Ramaswamy:          

I think the most common concern that they have is that their whole life has changed now. And that they’re going – this cancer is going to come back and when it comes back, they’re going to die. So, I mean, the death and the fear of recurrence is probably the most common concern. And I think the second common concern is the treatment-related toxicities that we talked about a little bit, particularly the hair loss or other things that’s going to change their lives forever after that. So, I think what is important to discuss to me, the most important thing to discuss is to clearly state to the patient there’s chances of cure. Meaning to say, your probability of being cured of this cancer, if you do this, this, and this is this high.

But there is, of course, a chance of 10 percent, 15 percent, 20 percent, 25 percent depending on the subtype of cancer they have  and the staging and their age and all of that, of this coming back. If you, even if you do the treatments, but if you don’t do the treatments, the chances of coming back is this much higher, okay?

So, I think it’s important for them to know it is still very difficult because it doesn’t really reflect what is going to happen to them. It reflects what’s going to happen to 100 people with similar cancer. So, again, that is important to explain, but what you can explain to them is if you pull out 100 out of the 100 pellets in a box if you pull out 90 pellets, they’re all going to be cured. There’s only going to be 10 pellets   that could have a recurrence. So, some ways to make them understand statistics. Not everybody comes with a good understanding of all of this. So, I think that’s important. And I think that also it’s important to talk about the treatments and how it effects – and how long it can affect them.

That they can get back and the goal of every provider is to really, the way I explain to them, you’re going to take a diversion in your life, but my goal is the diversion meets the main traffic at some point. That is the goal. And then you just go on smooth sailing. Of course, nobody knows the future, anything could happen, but we are here. And I think  the other thing that’s important, yes, we could have metastatic disease, but you are not going to, I mean,  I’m not saying nobody would, but most people with metastatic breast cancer live for several years.

And there are several treatments and new treatments  coming like I said, every year. So, having that positive approach, even if it comes back is so important for them. So, I think those are the ways; educating, answering their question, providing emotional support, and if they need counseling, addressing that. I think those are very important.

How Can a Prostate Cancer Social Worker Help You?

How Can a Prostate Cancer Social Worker Help You? from Patient Empowerment Network on Vimeo.

How can a prostate cancer social worker help patients and their families? Linda Mathew, a senior social worker, shares how she provides support for patients and their loved ones after diagnosis, during treatment, and beyond.

Linda Mathew is a Senior Clinical Social Worker at Memorial Sloan Kettering Cancer Center. Learn more here.

See more from The Pro-Active Prostate Cancer Patient Toolkit

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Tools for Managing Prostate Cancer Fear and Anxiety

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Caregiver Support: Taking Care of YOU



Linda Mathew:

Hi, I’m Linda Mathew, and I am a senior social worker here at MSK. I am a supervisor in the Department of Social Work, but I also have a service, and I work with the urology service, so, both medicine and surgical patients.

 And, really, it’s just – I’m here as clinical support to our patients in terms of individual counseling, couples counseling, family counseling.

So, what we really do is we provide supportive counseling to our patients. So, in terms of when we say “supportive counseling,” if patients are anxious, or have some depression around the diagnosis, or have just fears around what that – what it means to have a cancer diagnosis and the uncertainty about what that journey will look like, they are referred to me to just process that out loud in terms of questions about themselves and how – how are they going to manage a diagnosis if they’re going to be on chemotherapy or questions about how to support their family around this diagnosis if they don’t even know how to have this conversation with their family.

Most times, if it’s a couple that come in, it’s around how do I support the patient as well as the caregiver through the trajectory of this patient’s treatment. So, the patient is dealing with their own diagnosis and treatment and what all that means, and the caregiver is also having a parallel process with this where they are caring for the loved one, but also have their own fears about “How do I navigate being a support to them? I don’t know what it means to be a caregiver for somebody who’s going through medical treatment.”

So, we help slow that down for them and say, “These are the things that you need to look out for. Just – you are their extra advocate. You are that person – their eyes, their ears – when they are not able to call the doctor’s office to be able to say, ‘I can call the doctor’s office with this information. Just tell me what you want me to say.’”

But, you’re also just there as a support, so it’s a really weird kind of…reminding our patients the tools that they already have, but because they feel like they’re in a crisis, they forget what those tools are.                

Please don’t feel like you have to figure this out on your own. Your medical team is here for you, social work is here for you, we have an ancillary service – like, services available in terms of the men’s sexual health clinic integrated medicine counseling venture, all in terms of supporting our patients. So, when in doubt – and, if you don’t know who to turn to, just turn to your social worker and ask them. Say, “I need help,” and we’ll guide you through it.