Waiting for biopsy results might not be healthy

When the biopsy results arrive, the waiting will stop. You'll either resume your previous life with its commitments and deadlines and blessed routine. Or you'll begin a new life, one punctuated by blood tests and treatments and only sometimes controllable fear.

But the results aren't in yet. And so you wait, seemingly forever. To say that this state of not-knowing is stressful would be an understatement. To say that it could harm might not be.

In a study published in the March issue of Radiology, researchers periodically measured cortisol (commonly known as the stress hormone, though there are actually several) in the saliva of 126 women who had undergone breast biopsies and were awaiting the results.

At the end of the testing, those women who didn't yet have a final diagnosis had similar cortisol profiles as the women who had received a diagnosis of cancer.

As the abstract says: "Uncertainty about the final diagnosis ... is associated with substantial biochemical distress, which may have adverse effects on immune defense and wound healing. Results indicate the need for more rapid communication of biopsy results."

In other words, not knowing can negatively affect physical health -- and that's the last thing a person preparing to battle cancer needs.

And although many doctors don't like to deliver bad news over the phone, if a phone call is what it takes to end the uncertainty, then a phone call might be what is needed.

Writer Deborah Lewis makes the case for the compassionate phone call in a thoughtful essay on the benefits of hearing bad news -- "you have breast cancer" -- as soon as possible. In When getting cancer results over the phone is a good thing, she writes:

"There is no way of understanding the receipt of such tough news without understanding the particular torture involved in waiting for medical test results. Time slows down and becomes caustic. The mind fixates on floating scenarios unmoored to actual facts, intruding constantly into weak attempts at daily living.

If I am going through that slow drip of waiting, I want to end my torment as soon as possible."

Others who have awaited biopsy results would likely agree with Lewis. There's much to be said for knowing as soon as possible -- with a plan to discuss the matter in more depth immediately after the initial mind-frying shock has worn off.

Your mental and physical health might depend on it.

-- Tami Dennis

Comments

[Brian]

I'll never forget when I found out - it was a mole removal that I wanted (the doc didn't think it was worth the trouble, but did it anyway). I wasn't even expecting a call...and maybe I should have. But, nearly completely healed, I received a call from a nurse I had not met while at work. In a thick accent she said it plainly. "Brian. You need to come in. You have cancer. You need surgery. It's ok." I was completely floored - had they found something in the blood test? Was the mole cancerous? This nurse didn't explain anything beyond her original statement. "You have cancer. It's ok." In a myriad of emotions I was able to convince her to have the doctor call me. The time in-between that call and hearing from the doctor was sickening...once the doctor called he said it was "basil cell" - essentially the lowest form of skin cancer. It was all on the surface of my skin and (we later found out) not underneath.

It wasn't a surprise to find out the name of this nurse was never given to me...in all the follow ups she must have been hiding. Or maybe it's because they make these calls all the time that it's old news. Yet, it was clear they didn't realize that bedside manner extends out of the office and hospital.

[LInda]

I agree that results over the phone are the most humane way to get started on your trip to "Planet Cancer", however, my physician made an error when calling me with the news and dialed my work number instead. She left a very detailed message on an unidentified machine with the worst news imaginable. My bosses found out hours before I did.

This is an ocology department head at a national cancer institute in the Los Angeles area. It is not a small-time GP or internist who is unfamiliar with bad news., I know this could be a lawsuit, but I love my doctor. She made a mistake, as all people do. She is overworked, overbooked, and understaffed. My point is that if my brilliant and wonderful doctor made this mistake it could happen to anyone.

The phone calls need to be made, but parameters should be followed about double-checking the numbers and not leaving terrible news on answering machines!

I am glad that it was my workplace that received this awful news instead of my child (who is likely to have taken the messages at home from the machine). I can imagine the horror if this happened to a patient who would not want their workplace to know before they chose to tell. Luckily, I am okay with the truth being out.