Oncologists should be good listeners: Dr. Shanta

Meet stresses need for trust in a doctor-patient relationship

Dr. V. Shanta

A major issue in oncological care, which becomes extremely relevant for Teenage and Young Adult Cancer (TYAC) patients, is doctor-patient relationship, said V. Shanta, chairman, Cancer Institute.

At the seventh national conference of the Teenage and Young Adult Cancer Survivors — TYACON 2018 — held on the theme of “Breaking the Myths”, she said, “Individualised care is a vital component of oncologic care in general and specifically very relevant and more important in this group of TYAC patients.” TYAC refers to those in the 15-29 age group.

A patient with a diagnosis of cancer is already in a state of extreme fear. This group is already in a changing transition phase of life — growing, attaining puberty and hormonal changes, period for decision on their future, she noted. A diagnosis of cancer in this period causes significant mental disturbance and needs compassion, consideration and personalised management — both by the treating physician and family, she added.

“The oncologist’s skill in communication and listening are vital and can make all the difference in piloting the patient through the different phases of treatment. Doctor-patient relationship is a sacred one — one of trust and confidence. You have to be worthy of the trust,” she said.

Paediatric protocols

Dr. Shanta noted that it was claimed that paediatric protocols although show improved survival in the TYAC patients, there was increased toxicity. Adult protocols do not seem suitable, she said.

“Fertility preservation, psychosocial support, prevention of cardiac and pulmonary morbidities following anti-cancer drug use need careful consideration in case of teenage and young adults when you are planning treatment with possible long-time survival,” she said.

T.G. Sagar, director of Cancer Institute (WIA), said, Teenage and Youth Adult Cancer constitute six per cent of all cancers, as per the tumour registry.

Leukemia is the most common malignancy in both male and female. In male, lymphoma, bone, testis and connective tissue are other common cancers, while it was thyroid, breast, ovary, lymphoma in female.

While 28.8% had no treatment or had incomplete treatment in this group, 36% were treated elsewhere. Only 34% of patients received full treatment at the institute, highlighting the issue of non-compliance in this group, Dr. Sagar said.

Overall, five years survival in this group was 65%, he added. Among others, Prakash Chitalkar, director, TYACAN Foundation, was present at the event.