If you want your primary care doctor to take your symptoms seriously, avoid mentioning:
a) that you've been stressed out lately.
b) that you had a friend or family member get sick or die recently.
c) that you've been reading about X illness online.
I've seen at least 5 cancer diagnoses that had been delayed this past month from between 2 months to 2 years because the patient did something like this, and the PMD decided to blow off the abdominal pain, the weight loss, the diarrhea, etc.
Blown off. At least that's how the story gets reported to me by the patient.
Stage 1 cancer, with an 80% 5 year survival turned into stage 3 with a 40% 5 year survival. That's how they see it.
As I interview them, I think about whether I might have done the same thing had I been their PMD. Would I have chalked the 5lb weight loss to a normal fluctuation? To grief? The diarrhea to IBS? Or would I have been able to say, OBVIOUSLY. Let's get a colonoscopy/ EGD/ CT Scan. Now.
Afterall, hindsight is always 20/20, isn't it? For doctors AND for patients.
2 Pearls of Wisdom:
Remember oncologists only see those patients who eventually are diagnosed with cancer, so they miss the other 99 out of 100 anxious patients who come in to see their primary care physician fearing they have something, but only have anxiety.
Many times primary care doctors will also give patients a month of watchful waiting to see if the symptoms go away before doing an expensive and radiation filled workup. Again, most cases fall out. If every time a patient came in with concern about cancer they received a CT scan we would likely create more cancers than we'd discover.
As one mentor taught me, "If you are a hammer you see the entire world as a nail."
So totally true. It's hard to remember that when you're the specialist who sees 10 people with pancreatic cancer per day that most people with abdominal pain DO NOT HAVE pancreatic (or any other) cancer.
On the other hand, I'd probably feel like the patient if it happened to me. This is something I struggle with.
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