Day 1 at the cancer clinic.
A new diagnosis
Let’s suppose you have been given the devastating news of a cancer diagnosis. As a Registered Nurse working at our local cancer clinic for 18 years, this is the scenario I witnessed numerous times.
Yes, you got “that” call.
You know that you have an appointment at the cancer clinic to see the specialist. Your head is swarming with questions. You reflect on others you knew that also had cancer. You think of those who have died but quickly push those thoughts away. You can’t imagine that happening to you or even consider that it might. There is a sense of panic, maybe even desperation. Your mind is all consumed by this diagnosis. You try to take a few deep breaths as fear soaks in like water on a paper towel.
Arriving at the cancer clinic
The day of your appointment has arrived. You circle the building looking for a place to park. There is a parking building, outdoor and staff lots. Eventually you find the A Block entrance where you are supposed to enter. You park near the A doors and reluctantly walk toward the building marked Regional Cancer Program. You don’t really want to be here. No one does.
Hesitantly you walk through the doors and check in at reception. Forms are completed and you are handed a pager. You take a seat in the large waiting room, filled with an overwhelming number of people, young adults, middle aged individuals and seniors. You look around and make eye contact with a few people. Some are alone, others have support with them. Some are in wheelchairs. You are relieved to see no one in a hospital bed, and no children. This is adult oncology.
You recognize no one but feel overwhelmed by how many people are there. Settling into your chair you notice the constant movement. People coming and going, nurses collecting patients one by one. There are gentle smiles. A volunteer offering coffee. A porter assists someone in a wheelchair. A dietician delivers nutritional supplements to a patient. A lab tech walks by with a basket full of needles. You quickly look the other way.
Meeting your care team
You have been waiting well past your appointment time when your pager suddenly goes off.
Startled, you look up and a nurse calls your number. You stand, take a deep breath and follow her to the examination room, your heart racing.
Introductions are made and learn about what to expect from today’s appointment. The nurse explains the type of specialist you will be seeing and introduces the multidisciplinary team that may be involved in your care. A medical history is completed and your medications and allergies are reviewed. Your blood pressure, pulse and temperature are checked and recorded.
The nurse leaves and more time passes. Your stomach growls and you wish you had eaten a bigger breakfast.
The physician enters and you learn he is a resident physician, a doctor completing specialized training. The history is reviewed again confirming what you have already shared with the nurse. He performs a physical assessment. You are relieved you don’t have to change into a blue hospital gown. He answers some of your questions and leaves the room. More time passes. The door opens again.
Learning about your treatment
Your cancer specialist enters with the resident. Biopsy results are reviewed, and you learn that additional testing may be needed for something called staging. They explain that staging helps determine whether the cancer has spread elsewhere in the body and may involve imaging such as a CT scan, PET scan or MRI.
You swallow hard. You hear unfamiliar terms and wonder how you will ever keep all this information straight. You are asked if you have any questions but your head is spinning. You don’t know what you don’t know. Your heart continues to race, your hands might be sweaty.
Your stomach growls again.
The nurse, now a familiar face, returns. She acknowledges how overwhelming a first appointment can be. You sign consent forms for the proposed treatment and receive information packages outlining the plan. You are given a chart number, important phone numbers and educational pamphlets.
The nurse escorts you to the lab for bloodwork. On the way you pass the pharmacy where cancer medications are prepared and dispensed. Several people are waiting for
prescriptions.
You also pass the chemotherapy department. Your eyes drift inside for a moment. You see several people sitting in recliners with intravenous lines attached. Quickly you turn your head and stare at the floor noticing the well worn carpet. The nurse asks if you would like a tour of the chemo department. You politely shake your head no.
At the lab you take a ticket and wait for your number to be called. The smell of rubbing alcohol mixes with the aroma of fresh coffee. There is a Tim Hortons coffee shop on the lower lever and business appears brisk. You consider grabbing a coffee but your number is called.
You rise and approach the lab technician, who greets you with a smile and confirms your identity. Your arm is cleaned with alcohol, and with practiced experience, she draws your blood. To your surprise, it is quick and nearly painless. She labels the tubes and tells you, “You are free to go.”
Going home
It’s been a long, exhausting day. You are tired and just want to go home. The amount of information you received is overwhelming. Lunch has come and gone and you are hungry and thirsty. You are grateful you brought someone with you to this first appointment. As you leave the building the same way you entered hours earlier, you take a deep breath and feel the weight of exhaustion settle over you. The waiting room is still full as more people continue to arrive. You are surprised by the sheer volume of people receiving care. Then you learn that approximately ‘one in two people will be diagnosed with cancer during their lifetime,’ as stated by the Canadian Cancer Society.
Fortunately, many cancers are treatable and curable. You hope you are in that category. On your way out, you stop at the parking payment machine. $14. You consider purchasing a parking pass since you’ll likely be returning for many appointments. You decide to look into it next time. Although drained, you leave with a sense of hope. After all, they are offering treatment. You hope this plan will help you slay the dragon.
With the abundance of information you received, you realise you don’t remember everything
that was said. As you ride home, more questions come to mind. You try to focus on the road
instead of your thoughts.
When you arrive home, you begin reviewing the paperwork you were given but quickly realize you have no energy left to absorb any more information. You are exhausted, hungry and cautiously hopeful.
People began messaging and calling. How did it go? What’s the plan? When do you go back? Is it really cancer? You don’t answer, not yet. You need something to eat and a place to rest. The couch is calling your name.
Next steps
Over the coming months or perhaps years, you will return to the cancer clinic many times.
Gradually, the environment will become more familiar. You will learn some of the terminology and understand more about your treatment. The important thing is that you understand the
information being shared with you.
Ask questions until you feel confident in your understanding.
Ask about all available options. Those options may change as your health changes, and as you move toward recovery, discharge from the program or for some, end of life care.
You will discover that future appointments are often shorter and less intimidating. You will come prepared with a water bottle, snacks, and perhaps a book if you can focus on reading. The chemotherapy unit recommends bringing a sweater, as the treatment area is kept cool to help reduce nausea. Warm blankets are available if needed. You decide to bring a companion whenever possible for support and company. In reflection, you realise just how much that support mattered.
This is a typical scenario, although every patient’s journey is unique. From a patient’s perspective, it is a tremendous amount to process. Knowing what to expect can reduce fear
and uncertainty. Understanding the process can help. Fortunately many cancers today are treatable and curable.
Cancer affects more than the body. It impacts emotions, relationships and daily life. Having support throughout the journey can make a meaningful difference. As a Registered Nurse,
Death Doula and Grief Educator, I am here to walk alongside you and your family, helping you navigate the uncertainty, understand your options and feel supported every step of the way. You don’t have to do this alone.
Lets talk,
Jayne Dill
Londondeathdoula.ca