World Cancer Day: You have to be empathetic but clear, says leading oncologist

myUpchar had the opportunity to chat with leading orthopaedic oncologist Dr. Vivek Verma to discuss his experiences in this field.

Myupchar February 04, 2020 13:05:19 IST
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World Cancer Day: You have to be empathetic but clear, says leading oncologist

To mark World Cancer Day on February 4, all through this week myUpchar will bring to you stories about cancer survivors, their families, as well as cancer surgeons and doctors. 

Last week, doctors at Max Vaishali addressed the media to discuss two rare cases involving bone cancer. A 19-year-old and a six-year-old boy required limb salvage surgery along with chemotherapy to combat the disease. The surgeries required specialised skills of an orthopaedic oncologist, and there are less than ten in the country with such expertise.

World Cancer Day You have to be empathetic but clear says leading oncologist

Representational image. Getty images

myUpchar had the opportunity to chat with leading orthopaedic oncologist Dr. Vivek Verma to discuss his experiences in this field.

On his professional background and medical specialisation 

Dr. Vivek Verma: I started off as a trauma and joint replacement surgeon in Chennai. In my six years there, I noticed that in the case of complicated orthopaedic procedures, specifically those involving musculoskeletal cancer, the results were not desirable. There was an oncologist there with whom I often discussed my cases. He suggested that I also train in oncology to complement my orthopaedic training to tackle these difficult cases. It was then that I enrolled myself in the Tata Cancer Hospital (in Mumbai) where I trained as an orthopaedic oncologist. 

On his approach as an orthopaedic oncologist to treat patients

Dr. Vivek Verma: To put it simplistically, orthopaedists will not interfere with nerves and blood vessels around a bone. They ensure that they are well out of the way during any surgery. Orthopaedic oncologists though will first identify crucial nerves and vessels around the site, and identify and protect them. Only then will they approach the tumour and attempt to remove it without disturbing the rest of the area. The goal is to make sure the treatment is targeted and to preserve the functioning of the limb. Chemotherapy is provided as needed to further reduce the disease and push it into remission. 

On interacting with patients with life-threatening conditions, and his perspective on it

Dr. Vivek Verma: I’ve been in the medical profession for 20 years now. Right from the first year of MBBS, we hone our skills on cadavers - so the reality of death confronts us from the beginning. A lot of us already know going in what we will be dealing with, and those who don’t get used to it eventually. Perhaps as doctors, we are more aware of the fragility of life. With difficult diagnoses, you need to be sensitive, develop strong soft skills and communicate very clearly about the situation. 

Saying that the outcome is poor is not only blunt, but it robs the person of all hope. Yes, the situation is bad, but as a doctor, you operate using a certain protocol which involves detailing all options available to the patient. The case may be that there is a treatment that is unlikely to work, but it needs to be put forward to the patient anyway. As a human, you have to be empathetic and as a doctor, you have to be clear and offer comprehensive outputs. 

On whether maintaining a positive mindset can have more than just a placebo effect on health outcomes

Dr. Vivek Verma: Every person is different. Some will naturally not let things get to them and some may let all kinds of issues hassle them. There’s no right or wrong in this; it’s just how people are, and they cope with situations the way they can.

As for a positive mindset, I think there are many benefits. As we discussed, most things are out of our hands. Not too long ago I was discussing a treatment plan with a patient and their caretaker. Just before treatment started, I got to hear that the caretaker had suddenly died in a car crash. So what can you do?

There are therapeutic benefits too. Even though we can’t physically touch the effects of anxiety and stress on our body, it takes a toll on us. The latest research is showing how stress leads to bodywide inflammation and causes a host of issues. So managing these feelings of insecurity are important when you are going through a big crisis like this. 

On advising parents of young children and how they can deal with the uncertainty of illnesses

Dr. Vivek Verma: For starters, specifically with musculoskeletal issues, if there is bone or joint pain that is not subsiding and keeping you awake at night, you should at least get a doctor to check it out. If you bruise easily and the swelling doesn’t go down, it could point to an underlying condition. 

As for the rest, the advice is simple but important. Lifestyle really is so crucial: eat right, exercise at least a little, get your sleep, don’t smoke and moderate your drinking. This is easier said than done and sounds hollow, but you must actively involve yourself in working towards these goals.

For more information, please read our article on bone cancer.

Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.

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