The Psychosocial Impact of Ovarian Cancer - Episode 2
Shubham Pant, M.D.: Let’s say a patient comes to you. What kind of techniques can they use, or medication? What kind of techniques can they use in a psychological aspect to try to deal with this diagnosis? Are there any tips you can give to some of the patients who are going through it?
Jeremy Hirst, M.D.: Often what seems to help the most is to look back in someone’s life and see at other times in their lives when they’ve faced challenges, what has helped them through those challenges? It’s hard to all of a sudden develop a new coping strategy in the midst of a crisis. For some people, if they’ve had a medication practice, make sure they stick with that. If they’ve had an exercise routine that is stress relieving, stick with that. Reaching out to friends and family is often a universal way of getting support. Faith is another frequent method for folks who have had a real spiritual or faith-based life; not giving that up right now is a good idea. And then certainly seeking out professional help for a lot of folks is helpful, whether it’s with a psychologist, a psychiatrist, social workers, peer-like support groups or more professional support groups. There are a variety of things.
Shubham Pant, M.D.: That’s very important. If you need help, ask for help. I think that’s the important point. I know it’s been about three years, but do you remember anything in regard to emotions or what you were thinking about, what was going through your head when you were just diagnosed? Was it exactly as Dr. Hirst said, gut-wrenching? Were you like, “Whoa, my life is stopping. I need to find somebody to treat this?” What kind of emotions went through your mind at that time?
Doña Harman: I honestly don’t remember the emotion. I know that it was terror, though — I’m sure it was — and just trying to find some control in a situation where I didn’t feel control. For me that was found in researching it. I did go on the internet to very reputable sites. I went to JAMA, ASCO [American Society of Clinical Oncology], ESMO [European Society for Medical Oncology], OncLive®, where they have actual physicians talking about it and talking about the research. And one of the things that helped me navigate the journey was to realize that there are a lot of new therapies coming up for ovarian cancer. Having ovarian cancer today is much different from having it, say, 10 years ago. That brought me solace, but I’m sure I drove Dr. Eskander crazy because I was just asking, what about this and what about that?
Shubham Pant, M.D.: Dr. Eskander, is that how you remember it?
Ramez N. Eskander, M.D.: Actually, it’s exactly as I remember it.
Shubham Pant, M.D.: But I think you’re right, there are a lot of emotions and everything you go through. And you’re right, Dr. Hirst. As you said, there is some denial that would be in all of us looking at it, saying my life was really going well, was perfect, and then suddenly I have to readjust my life to deal with this. But I think, Doña, what you did was close to perfect. You researched it a little, you took good advice, you found a doctor whom you were confident with, and you followed the path. That was amazing. But tell me this. Doña, I’ll start with you. Are there a couple of pieces of information that you could relay to somebody who’s just dealing with ovarian cancer? Let’s say somebody has just had a diagnosis of ovarian cancer — it’s all new to them. What kind of advice would you give them?
Doña Harman: Well, I think just what you said, find a doctor whom you know you can go on this journey with, that you can trust. And Dr. Eskander — I don’t know if you still do this — gave me a number where I could text him. And he said, “I do this for all my patients. You’re not special, this is what I do.” I just felt I had a connection, a lifeline, and that I knew we we’re in this together. He’s invested in me, and I’m invested in him. I would encourage patients that it’s everything: finding a good doctor at the very beginning and then doing the work. That’s showing up, getting your scans, doing the chemotherapy, following all the scientific work that’s been laid out before you began this journey. That would be No. 1. And No. 2 is, I would try to worry a little less. I don’t talk about it, but I know nights seemed to be the hardest time for me. I remember the tool I used, because I don’t really meditate, was coming up with the “I am safe tonight. Tonight, nothing is going to happen to me. I can go to sleep, just rest, don’t worry about tomorrow.”
Shubham Pant, M.D.: That’s amazing, Doña. Dr. Eskander, what information would you relay to a newly diagnosed ovarian cancer patient?
Ramez N. Eskander, M.D.: I echo a lot of the things Doña just mentioned. I think communication is critical. Patients are coming into this with a new diagnosis, as Dr. Hirst just said. They’re fearful, apprehensive about what may come, and worried, especially in the context of an ovarian cancer diagnosis. But communicate, find the physician whom you feel like you can truly reach out to, where the dialogue is an open dialogue and who spends the time that’s needed to talk to you and your family throughout this process, and have some degree of faith that this process is going to move forward. There will be steps along the road. We may run into some bumps in the road, but we’ll get beyond them. I echo what she just stated as well. I had another patient who taught me a phrase, “Don’t borrow trouble.” And I learned it and use it a lot because I think it’s really meaningful in this disease. We treat ovarian cancer. We don’t know what’s going to come. We don’t know what’s going to come in a month, in a day, in a week. Where we are right now is where we want to be. This is where our focus is, and we’ll exert our energy at this stage. Then we’ll revisit this as we progress along the course of your therapy.
Shubham Pant, M.D.: That’s a really good one. I’ll remember that too. Dr. Hirst, what advice would you give somebody who’s newly diagnosed with cancer?
Jeremy Hirst, M.D.: I think reaching out to those around you is important. Certainly finding a physician whom you have a good connection with is important. And worry is normal, but it can get in the way if you’re worrying all the time. I think that technique of, “OK, right now I’m OK, right now I’m safe,” is appropriate. Have time to worry, and then set it aside so you can move on with the other things you need to do. Getting sleep and whatnot is important. But for a lot of folks, not keeping it a secret is helpful.
Transcript Edited for Clarity