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Physician
Selection
- Most endocrinologists,
pediatricians, otolaryngologists, and pediatric surgeons have little
or no experience with treating thyroid cancer in children.
- With pediatric
thyroid cancer accounting for less than 1% of all childhood cancers,
the search for experienced doctors should be done carefully.
- Even the physicians
most experienced in treating this disease have encouraged patients
to get second opinions when dealing with children with thyroid cancer.
- Most cases of
pediatric thyroid carcinoma are not immediately life-threatening,
so, when the diagnosis is made, take the time to find a doctor or
medical center experienced with the management of this disease.
- It is vital to
do things correctly from the beginning, particularly surgery, so seek
out the best treatment for a child. Remember a child's best advocates
are his or her parents, and no physician will fault a parent for seeking
out the best treatment available.
Doctor-Patient
Relationships
- Having good communication
with your doctor is one of the keys to getting good medical care.
- Being able to
communicate with your doctor helps ensure that there is understanding
about planned treatments and that the child or adolescent receives
the proper treatment, thus aiding in the eventual outcome.
- Studies have
shown that in any type of crisis, the outcome is better when the people
involved have a good working relationship.
- If your child's
physician is not a pediatric thyroid cancer specialist, he or she
should be open to consulting with a pediatric thyroid cancer expert.
- You want the
best care for your son or daughter, and the best doctor. You are bringing
your son or daughter to the doctor for medical care, not for you to
find a new friend. Remember that your family is taking the time and
transportation to receive care, and usually is paying the doctor,
often through insurance and co-payments. It's your child's body and
your time and money.
- If your child
isn't getting good care or if you find it difficult to communicate
with your child's doctor, find a physician who is knowledgeable about
thyroid cancer and with whom you can communicate well.
- For geographic
lists of physicians who are thyroid and thyroid cancer specialists,
visit the Find a Specialist page of the web site: http://www.thyca.org/specialist.htm
Questions to
Consider
Here are some questions
to help you decide if you and your child's doctor are on the same team
and make good partners.
- Does the doctor
welcome questions from the child or adolescent with cancer, as well
as from the parent(s) or guardian(s)?
- Is the doctor
available to give you information and advice by telephone, fax, and/or
e-mail?
- If you ask in
advance for a longer appointment time with your child's doctor, are
you able to get it?
- Does the doctor
always explain why he or she is recommending a particular medical
test?
- If you or your
child are unclear about what the doctor is saying, will the doctor
take time to rephrase it?
- Does the doctor
use technical medical jargon all the time, or does he or she speak
in terms you can understand?
- Does the doctor
address your specific concerns, instead of offering "one size
fits all" medical care?
- Does the doctor
ask you what medications the child or adolescent is taking, both prescription
medication and over-the-counter medication?
- Does your doctor
describe treatment options and explain them carefully? Does the doctor
explain the benefits and possible side effects of recommended treatments
and medications?
- Does the doctor
help you and your child feel calm and comfortable during the appointments
and discussions?
- Does your doctor
treat both you and the young patient with respect?
- At the end of
the appointment, does the doctor ask if you and the young patient
have any further questions or concerns?
- Will the doctor
encourage you to seek another opinion if you want it? Will he or she
help you arrange for that second opinion, including suggesting a pediatric
thyroid cancer expert?
- Does the doctor
help you understand or get someone in the office to help you understand
your insurance benefits if you are unclear about them? If you do not
have health insurance, is there someone in the office with whom to
discuss payment issues?
- If you are unhappy
with the doctor for any reason, do you feel comfortable telling him
or her?
Tips for Remembering
What Your Doctor Says At the Appointment
Adapted from Teamwork: The Cancer Patient's Guide to Talking With Your
Doctor by L.R. Brusky and others.
- Take a family
member or friend to the appointment. Two sets of ears are better than
one.
- Take a tape recorder
if necessary. (Make sure to ask if it's all right to tape!)
- Take notes. Keep
a journal of questions, answers, and comments about the appointment.
- Ask for an explanation
of unfamiliar terms and definitions.
- Ask for a visual
aid. Seeing what your doctor is talking about on a chart or visual
aid will help you and your child remember.
- Ask if the doctor
has any printed information to give you and your child. Ask for the
availability of other resources.
- Ask questions.
Don't be afraid to be your child's advocate. To ensure that you understand
the answers, paraphrase the answer back to the physician and ask if
that's correct.
- Give your doctor
feedback on what he or she has just told you and your child.
Questions
to Ask the Doctor
Adapted from When Your Doctor Has Bad News by A. B. Weir, M.D., Oncologist
- How confident
are you of the diagnosis?
- What will this
problem do to the length and quality of the young patient's life?
- What is the best
treatment?
- Should we seek
another opinion?
- Are there any
research programs (clinical trials) that we should consider looking
into?
- What nutritional
or complementary approaches might be helpful?
- If the child
or adolescent were your family member, what would you advise us to
do?
More Questions
To Consider Asking the Doctor
http://www.thyca.org/questions.htm
For the Patient:
Establish Some Goals
Adapted from When Your Doctor Has Bad News by A. B. Weir, M.D., Oncologist
- How will I learn
to live with my illness?
- Who am I now?
How can I matter?
- Do I have a new
mission?
- Can this type
of life be my finest hour?
- What gifts can
I give?
- How do I best
prepare my loved ones to live with my illness?
Last updated:
October 4, 2006
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