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The Surgical Decision: Assessing and Discussing the Patient's Options
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Dr. David Harpole, Duke University Medical Center, describes how he assists patients with the surgical decision-making process.

 

 

Transcript

As a thoracic surgeon, we are the physicians that a lot of patients come to with lung cancer. Unfortunately, the outcomes for lung cancer have not been great, and I would say that there are some physicians that are surgeons where the patients come to them and are wary and don’t want surgery. It’s pretty much the opposite in lung cancer, most patients know that if we’re able to take the tumor out, that’s their best chance for survival.

So the first thing I do when patients come to us is reassure them that we need to adequately assess their strength and so forth for surgery, detail the extent of their disease which often involves not just surgeons but a medical oncologist, a radiation oncologist and an interventional pulmonologist in our practice. We discuss the fact that lung cancer is not treated with any one hammer — I usually say I use two or three different hammers depending on which modality we’re going to take on. Then at the location of their mass, we’ll take pictures from their CT scan and show it to them and discuss what are the surgical options, whether it’s something small that we can do with video-assisted techniques, or is it something that’s going to require quite a bit larger operation, then we discuss those with them.

I have a rule in my practice that I never let a patient decide on their care the very first visit that we have. We always want them and their family to spend time thinking about it, read the materials, then they come back and we decide on the best course of treatment. It’s an awful lot that comes at you when you’ve had the diagnosis of lung cancer and I feel like a judicious, slow approach is the thing that most patients appreciate from their physicians.

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