The Psychosocial Impact of Ovarian Cancer - Episode 6
Shubham Pant, M.D.: Do you see any movie on Fridays, or do you wait for specific movies, any movie?
Doña Harman: We are just movie fans. The only movies we don’t see are violent movies, both my husband and me, so we’re on the same page. But we love documentaries.
Shubham Pant, M.D.: That’s amazing.
Doña Harman: I like adventure films a little more than he does, and comedies. We just have always done this, since we started dating, we’ve been married for 36 years.
Shubham Pant, M.D.: Congratulations.
Doña Harman: I wish I had saved those old ticket stubs. Tom would do that when we were dating. I have a jar.
Shubham Pant, M.D.: To try to keep normalcy, Dr. Hirst, what do you think about that? Do you think that’s a good thing, to try to keep as normal of a life as possible?
Jeremy Hirst, M.D.: Yes. I think for a lot of folks it feels like so much has been taken away, whether or not you have to stop work, or you can’t pick up the kids from school for a little bit, or you’re unable to do your usual household tasks. It feels like a lot of losses, so where you can, maintaining normalcy helps and maintains a sense of strength and generativity through all this.
Shubham Pant, M.D.: Doña, what about nutrition and everything, did you change the way you eat, your patterns? Did you just keep a healthy diet, so you can go through the chemotherapy trying to keep a calorie count up and keep your nutrition up?
Jeremy Hirst, M.D.: I did not experience nausea to any degree. I never threw up throughout treatment. They have a lot of things they can give you now to navigate that. But I did battle constipation. That was probably my demon, and as a result I didn’t want to eat anything because I thought anything going in is not coming out. Food was just not attractive to me, so I had worked on trying to just keep my nutrition up during it, which I made up for after chemotherapy. I made a list of all the things I was going to eat.
Shubham Pant, M.D.: Did you eat them when you went through the list?
Doña Harman: Yes, yes, I gained a few pounds.
Shubham Pant, M.D.: That’s all right. That’s perfect. Dr. Eskander, how do you talk to patients about their quality of life while going through chemotherapy, how to maintain their quality of life? What are some of your thoughts on that?
Ramez N. Eskander, M.D.: It’s a very important aspect of care. It’s daunting enough to go through surgery and then chemotherapy. But if patients begin to run into a lot of chemotherapy-related adverse events that they weren’t expecting or weren’t educated about, they can develop fear, some apprehension. They worry about the effect it has on the cancer and cancer growth and not being able to tolerate the therapy. So I think a really important part of it is to educate, to inform them, and to help manage symptoms. And, again, this is a multidisciplinary process, and it speaks to the importance of having a great team around you, having good nutritionists and dietitians, having infusion center nurses who can call you and say, “Hey, Doña is not doing so well with her infusion. She looks dehydrated. She’s telling us she has a lot of nausea.” Because many times in our office, visits some of those things are lost in translation.
Shubham Pant, M.D.: It’s like a trailer. It’s not like a whole movie, right?
Ramez N. Eskander, M.D.: Correct, it’s a trailer. Or the patient doesn’t feel compelled to share it with you because they’re worried if they share it with you, it may affect their treatment.
Shubham Pant, M.D.: Yes.
Ramez N. Eskander, M.D.: It’s a multifaceted approach, but controlling symptoms to preserve quality of life and making sure that patients can continue therapy without significant side effects is really important. The cold cap is something that some patients elect to use, and it’s an example of a way to make them feel that they’re not going to lose their hair with therapy and give them a little bit more power. And as Jeremy mentioned earlier, there is that feeling of control over some things when you feel as if you have no control over many things at that point in time.
Shubham Pant, M.D.: Dr. Hirst, a couple of things. For patients who are going through this, what would you recommend for them, just in general. Are there ideas with your practice that you would recommend for them while they’re getting chemotherapy, to maintain their quality of life?
Jeremy Hirst, M.D.: Yes. I think as Dr. Eskander says that some folks do worry that if they share some of their issues, it will delay therapy or it will mean the doses aren’t as strong as they would otherwise be, and so maybe they don’t want to share that. But knowing that, well, we actually have things that can treat constipation really well or can treat nausea really well. And if we treat the physical symptoms and the emotional symptoms, you’re better able to tolerate the chemotherapy, or the surgery, or whatever the treatment may be. So trying to be as open and honest and getting help from your entire care team is important.
Shubham Pant, M.D.: So open dialogue and honest dialogue with their care team is exceedingly important in getting through the therapy.
Transcript Edited for Clarity