He has been investigated now and it is found out he has Metastatic Renal Carcinoma and after discussion with oncologist ,he says it is not possible to treat it by Surgery and only symptomatic / Supportive Rx can be given.
He is also found to have Congestive Cardiac Failure . Oncologist thinks he has only 4 months to live.
Break this Bad News to him.
Key points :
Introduce your self and confirm identity of patient.
Establish purpose of meeting and also ask the patient what he knows about his condition,blood and imaging tests and other investigations.
Try to establish if he knows what the problem might be ?
“ Do you know the purpose of our meeting today ? “
“ What do you think is wrong with you ?”
“We did some tests and the results are back” .
“I am afraid the results are not too good “
“ Do you want me to proceed with the results? “
“ Do you want to know the results of these investigations ?
“ Do you want me to call someone from your home to accompany you ?
“ You have been diagnosed with cancer of the Right kidney.
Offer some time for the patient to take this news before proceeding further.
Offer patients some tissues if possible.
Ask if he wants us to proceed further with more findings,if he wishes so ,tell him about his Metastasis finding .
“I am afraid the cancer has spread to other parts of your body from your kidney and the oncologist does not believe treatment of this cancer at this stage can be done ,neither surgery nor chemotherapy as it has widespread “.
But we will give you treatment for pain control and nausea .
Patient asks how much time do I have ?
Tell him ,the oncologist says you have only 4 more months to live.
Be specific and clear and honest about predicted prognosis.
Patient said he wants to go on holiday.
Encourage him to enjoy his time by going to holiday and doing the things and hobbies he likes to do and encourage him to spend time with his family as well.
Ask about his hobbies and tell him to engage in them.
Also if he wants to have another meeting with his family present .
Tell him to avoid dangerous hobbies but can have safe one
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