When I teach medical students, I always remind them that we will see people on the very best days of their lives and the very worst days of their lives. As a result, we will see every range of emotion in our patients and feel every range of emotion ourselves. This is especially true when giving someone a diagnosis of cancer.

Telling someone they have cancer is a daunting mission. Often, the patient suspects something serious when they are asked to come into the clinic to review results in person instead of getting a letter or phone call.

I always make a point to ensure my patients are accompanied by a family member or friend. Having another person in the room to support them is important, because often the person diagnosed with cancer does not always hear or remember much after the “C word” is spoken. The word can land a visceral reaction. And, while most of us know someone who has been affected by cancer, it is difficult to imagine what it feels like to have those words directed at you, until it happens. 

After a diagnosis of cancer is given, the next steps can happen quickly. There may be referrals to a specialist. Sometimes follow up exams and tests are done as soon as they can be scheduled, even on the day of the diagnosis. Having someone else in the room to help keep track of the information and offer support is helpful. 

When the diagnosis of cancer is first spoken, there is usually one of the five emotions of grief that Elizabeth Kubler-Ross described. Most often, I see denial and anger. Later there is bargaining and depression, but on occasion there is acceptance. I have told people they have cancer only to see them smile, nod their head, and tell me that they already knew, and I confirmed their suspicions. Each person has an individual journey, and they will cycle through all these emotions, often more than once. 

My hope as a primary care physician, is to never let my patients be alone in this journey. After a diagnosis of cancer, I refer my patients to specialists, but I am not done caring for the person. I let the oncologists take over in the fight against this disease. But I, and most primary care physicians, will always be there as a trusted advisor and friend who can help coordinate care and answer questions.

Jill Kruse, DO, is part of The Prairie Doc® team of physicians and currently practices family medicine in Brookings, South Dakota. Richard P. Holm, MD, founder of The Prairie Doc, passed away in March 2020 after a battle with pancreatic cancer.