talking to pts about possible CA dx

[VivaRN]

I had a pt's labs come back suspicious for cancer, she also had a few other suspicious masses that were not completely worked up in the facility she was in before coming to me. She is chronically ill with AIDS. I proceeded in my management but had to call the patient to let her know the plan (further tests pending, aggressive evaluation of masses).

(being purposefully vague to protect privacy)

When I called her about the plan with this new CA possibility I felt very unprepared and wasn't sure how to talk to her about this. I feel like I stumbled around and felt awkward trying not to scare her, but to also let her know this was a possibility and the importance of follow-up (we have a lot of problems sometimes with patient follow-up). I wasn't sure if I should use a euphemism like "something concerning we are taking a closer look at" until I'm sure, or come right out with the "C word."

Anyone have advice?

[traumaRUs, MSN, APRN]

I have a pt that had an alarming rise in light chains on an SPEP. I did talk with her quite honestly, referred her to an oncologist and let her know to come back and see me afterwards and we would discuss things further.

Although she cried initially (and I too gave the news over the phone), she appreciated my honesty.

I try to preface these discussions with something like: "those tests that we ordered have come back and you need more follow-up than I can provide (I'm nephrology) so I' sending you to a specialist".