Last fall, I was walking with my dog at our cabin in the Ozarks of Missouri. I had my camera. I came to a clear area, and, on a dead tree, I spotted a large bird and then another. For some reason, Maggie, our energetic Lab mix, was quiet. I watched the birds from a distance and took a series of photos. Then, without warning, all of these birds started to fly away. I almost put my camera away, thinking I'd had an enormously successful day of photography, when I looked up one more time. I focused on the solitary large bird and realized it was a beautiful eagle. It was something I do not see often and although he wasn't still long, I had the rare opportunity to watch. Waiting those few extra moments had paid off.
Often patients call and they tell me they need immediate genetic testing for hereditary breast cancer because of a recent diagnosis of cancer. They tell me they need to decide in the next day or so. I leave a few slots in my schedule each week, so, if a patient truly needs testing promptly for the purposes of treatment planning, we can get things started without delay. Genetic testing results usually take about 3 weeks for reporting and this adds a lot of stress for some patients.
I do think it is important for patients to realize that when they are diagnosed with cancer it's very stressful, and human instinct tells us to start some type of definitive treatment the next day. The reality is that in most cases cancer has been present for months or possibly years, and that not initiating treatment for another two to three weeks is acceptable and also very important.
More than ever before, patients are participants in decisions about how to treat a malignancy. They need enough information to make an informed decision.Genetic testing results often directly affect treatment decisions, especially surgical ones. Patients cannot make the best decision if they do not have all of the information. Taking the time to gather and consider that information is important.
When patients make a treatment decision they want to later be able to look back and say with confidence that they made the best decision based on the information that was available at the time. Sometimes it is clearer if you just wait and look at everything.