Worried Patient

Published

There was a young college student that came into the office for immunization for college. After talking to her briefly, I realized she has severe anxiety. Her grandmother died of lung cancer almost a year ago and she's deathly afraid of having the same outcome. We live in a small town in Pennsylvania. She used to go to college in Harlem, NYC, and is thinking of going back there in the fall. She is considering not going because it "could increase her chances of getting lung cancer". When I asked her why she thought that, she stated that there will be smokers outside of the dorms and maybe even inside because students break the rules. She will also be passing smokers on the street, on campus, air pollution, and living with smokers. I asked her what she did now for school because I thought it doesn't matter what campus anyone goes to, smokers cannot be avoided. She said that she goes to school online and does not have a job because of that fear. Being an LPN, I do not know loads about risk factors and how you get it but I assume that you can be a nonsmoker your whole life, live in a house and never leave like she is, and still get it. Any opinions? She said she did see a psychiatrist for it and it didn't help her at all. Is telling her to go really going to give her a greater risk?

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Specializes in mental health, military nursing.

The risk of lung cancer is not the issue, it's the anxiety. She has unrealistic fears that are hindering her ability to live her life, and she needs to seek long-term therapeutic treatment. Many people claim to have already tried psychiatric help, when all they did was get a prescription and never follow-up due to frustration with continued symptoms... Recommend her to a help-line in your area, or help her set up an appointment.

You're right to be concerned, and you are in a good position to help her with the next step! Good luck!

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Specializes in school nursing, ortho, trauma.

I think it would be benefical if someone (be it you or a psych counselor) discusses some of the basises of her fears. What risk factors may have predisposed grandma to lung CA? How much does your young patient know about lung cancer? Sure there have been anecdotal instances of 2nd hand smoke and lung cancer, but perhaps her perceptions are a bit skewed in the actual liklihood. I hate to think this girl has become a recluse to avoid walking by someone on the street who may be smoking.

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Does anyone feel that she has a point or is right in her thinking?

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Specializes in Med/Surg.
Does anyone feel that she has a point or is right in her thinking?

She has a point, she is at an increased risk of getting a potential fatal disease. But our genes predispose us to all sorts of things that could kill us. The fact that she has a point is valid, but the fact is it is to the point where her behavior is counterproductive and maladaptive, the very definition of abnormal, she definitely needs help.

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Specializes in mental health, military nursing.

Truthfully, living in the city for school is going to have a negligible impact on her health. Studies that link second-hand smoke to lung cancer almost always refer to living with a smoker... passing a smoker on the street is NOT going to give you cancer. Her fears are irrational.

She may have a greater genetic risk for lung cancer, but she can take steps to lower that risk through diet and lifestyle, not through avoiding other people...

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Specializes in CVICU.

accidental post

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Specializes in CVICU.
Does anyone feel that she has a point or is right in her thinking?
No. You can't possibly live a productive life thinking that way. Sure, passing the occasional smoker might increase her risk, but she's not going to have much choice in who she's around if she doesn't hold down a job and ends up homeless. Where's she going to hide from the smokers then? Plus, if she's really worried about it she should move far, far away from the city.

If she can't get past this, perhaps she should consider a more rural environment. And some Xanax.

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You can get lung cancer and never smoke. The second leading cause of Lung Cancer is Radon gas. I would bet 99% that are exposed to this never know.

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