3 Critical Suggestions for Improving Cancer Treatment Outcomes

After years working in Suffolk, England, Dr. Liz O'Riordan became a competent, skilled, knowledgeable oncological surgeon.

Last month, ecancer published her article, in which she said: “I thought I knew everything anyone could know about breast cancer. I was a consultant breast surgeon. I even had a master's degree in oncoplastic breast surgery.” She added: “I was wrong!”

This British surgeon would learn more. In 2015, aged 40, known then and on social media as Liz O'Riordan (@Liz_ORiordan), Dr. Elizabeth Louise O'Riordan was diagnosed with stage 3 breast cancer.

This new lesson came quickly and painfully. To help colleagues' medical education, she described “three simple things everyone can do to improve cancer care” .

Liz says oncology is “very good at delivering clinically effective, safe treatments,” but these are generally not enough alone .

“Where health care providers fall short… is patient experience,” she writes.

Medical oncologist Mark Lewis of Intermountain Healthcare in Murray, Utah, read the article and summarized its uniqueness: “The author explores the gulf between doctors' training and what patients need to know.”

Dozens of readers confirmed its compassion, impact, and memorability, including a Newcastle, England, palliative care specialist and author of “With the End in Mind: Dying, Death, & Wisdom” (Being Aware of the End: Death, Dying, and Wisdom), Dr. Kathryn Mannix.

She (@drkathrynmannix) tweeted: “I may be crying on a train, but it was worth it.” She wrote: “Every health professional should read and reflect on this. What do we REALLY know about the experience of patients we hope to help?”

Simple Suggestion Number 1

Liz begins by examining her profound anxiety about breaking bad news as a young doctor. “Nothing prepares you for the first time,” she says. “It is hard.”

Over the years, efficiency replaced anxiety.

“More than half my breast-surgery time was spent in clinic, telling many women most days they had cancer. I often felt I would break a woman, pick up the pieces, leave her, and repeat the process. It became routine…” she writes.

Experienced Liz summarized her skill: “I thought I was good at telling people they had cancer.”

Now she knows she was wrong : “…until you sit on the other side of the desk, you have no idea what effect your words have.”

She acknowledges a frequent mistake: “I told women with small tumors they were ‘lucky’ we caught it early. Nobody is lucky to have cancer.”

She recalls learning her diagnosis:

“Like most patients worldwide, I had to walk long hospital corridors, desperately stopping myself screaming, shouting, and swearing, taking the ‘walk of shame’ past everyone waiting to see the doctor,” she says.

This leads to her “First Simple Thing”: Direct Patients to Safe, Accurate, Friendly Information.

“Recommend useful books, websites, forums, and apps to browse with loved ones, providing support they do not yet know they need when leaving hospital.”

If this sounds burdensome, it is not, Liz says.

“Ask current patients for lists of sites they found useful. Trust me, they already do the hard part for you,” she explains.

Liz Emphasizes the Difference Between Knowing About Cancer and Experiencing It!

Radiotherapy was needed—a process she had never seen despite referring many patients—followed by tamoxifen tablets.

“I used to review menopausal effects, saying ‘most women adjust within 6 months.’ Who was I kidding? Menopause was awful—it happened overnight.” Liz says she sought help from other patients and a website for young mothers with cancer.

- Related topic: The moment time stops: RECEIVING A CANCER DIAGNOSIS!

Simple Suggestion Number 2

“Second, ensure every patient knows the signs of recurrence (cancer relapse) and what to do when worried,” Liz writes. This again means providing information after initial treatment and reviewing it at each follow-up. She notes: “Many patients do not realize cancer can return years later.” She comments:

“Patients must face fear of recurrence every day,” and information helps. She also believes in introducing patients to the term for mental distress while awaiting follow-up imaging results, scanxiety , scan-related anxiety.

- Related topic: 6 suggestions for coping with fear of cancer recurrence

Simple Suggestion Number 3

Living with cancer, Liz knows post-treatment life is more than annual scans. As a surgeon, however, “[patients'] returning to work, exercising, or having sex to reduce recurrence was something I never considered,” she says.

This Is Simple Thing Number 3: Address These Problems and Encourage Patients to Live Again.

“Menopausal effects of drugs taken for up to 10 years—loss of libido, vaginal dryness, and painful sex—can ruin relationships and lives, especially when young and single,” Liz says.

She admits her former self “never discussed sex after breast cancer with patients.” She acknowledges: “I did not think it was my job.” Now she believes it is the physician's responsibility where possible.

- Related topic: 5 things cancer patients and partners should know about sexuality

“Anxiety, depression, and post-traumatic stress disorder (PTSD) may appear months or years later when the reality of what you experienced, your appearance, and what the future holds begins to sink in.” Liz also advocates mindfulness.

Make the extra effort—it is not exhausting, she says. “Improving cancer care is really easy, and often the small things make the biggest difference. You only need to ask the experts.”