Are the long-term side effects of #cancer treatment underdiscussed?

Why My Primary Care Physician Is My New Best Friend

After my recent annual checkup with my primary care physician, I decided she just might be my new best friend, medically speaking that is, of course.

As I prepared for my appointment which really means as my list of things to cover continued to grow, I felt sort of guilty. I felt as if she was the one in charge, again medically speaking, of helping me pick up the pieces. And there were/are quite a few pieces to pick up! 

Don’t get me wrong, all the specialists (and there have been too many to list out) I’ve seen are great. I value their expertise immensely. But partly due to this expertise their “vision” tends to be very focused.

For instance, oncologist #5 has reminded me more than once that her primary job is to try to keep my cancer in check. I get that. I want that.

Since I now have a cancer resume, I realize I will always be thought of as a cancer patient from here on out by most of my doctors. Heck, even my dentist now “knows” and requests updates on things.

But I am more than a cancer patient. 

I am a whole person with whole body (and mind) issues that matter too.

All the other specialists I’ve seen and see still, wear “blinders” to a certain extent. It’s harder for them to widen their view of me. It just is.

When a person starts tiptoeing through survivorship, there can be a lot of cancer fallout to contend with. Unfortunately, many of you reading this blog know exactly what I’m talking about.

Even if you’re lucky enough to be “finished” with cancer treatment, there is a lot of cancer crap to deal with from there on out. I won’t bother to list out all my personal issues, but let’s just say I couldn’t cover all of them in one, though lengthy annual physical appointment. My PCP requested another meeting so we could discuss things further and yes, she did also end up referring me to yet another specialist… Like I said, I have a few issues…

What I love most about my PCP is her willingness to listen – really listen.

As I’ve written about before, too often doctors seem dismissive. This doesn’t mean they are dismissive, but sometimes impressions, good or bad, are what patients remember most.

Another reason I respect my PCP so much is because she not only listens, she offers me something else that’s intangible, but equally important – validation.

For example, she acknowledged the difficulty I’ve been having with side effects from taking Arimidex. She listened, but more than that she offered compassionate validation.

After considerable listening coupled with some pretty frank discussion, she said, “Nancy, I’m giving you permission to go off all AIs for one month. Let’s see if we can start getting you to feel better. Let’s just do it.”

Of course, it’s not like I needed her permission and I had pretty much already decided I’d be stopping for a short break, but hearing her say those words meant a lot.

It was validation.

She went on to say, “I don’t think you’ve recovered fully from cancer treatment. I don’t think your body has bounced back yet from the harshness of chemo.” (I’ll spare you the details).

More validation.

Next, and most importantly, together we devised a PLAN.

And I like the plan.

We have lots to work on, but at least now I have a PLAN.

This is such an important missing link for so many in cancer care survivorship.

Every cancer patient deserves a PLAN for survivorship because frankly, tiptoeing through this thing called survivorship isn’t as easy as it’s cracked up to be. Mostly because cancer and all the accompanying fallout is never really over.

So, while all the specialists in your medical life are probably pretty terrific, don’t underestimate the help and guidance your primary care physician might be able to offer you as well.

You might discover that yours is your new best friend too.

How many specialists have you been sent to?

What kind of doctor/patient relationship do you have with your PCP?

Do you have a survivorship plan, or have you discussed one with your doctor?

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Why my primary care physician is my new best friend


21 thoughts to “Why My Primary Care Physician Is My New Best Friend”

  1. I got a new PCP a few years ago and really like her. My old one was awful. The only problem I have now is my new PCP went out on maternity leave so I can’t see her again until October. But I can wait. Because she is worth it. A good doctor is worth their weight in gold.

    1. Caroline, The good news is that October isn’t that far away, right? And yes, a good doctor is very valuable indeed. Thanks for sharing.

  2. So how many specialists have i been to? I went from having zero doctors (I was between PCPs) to having 1 PCP and 8 specialists in one year.

    I made an appointment to let my PCP know all that happened when I was diagnosed. I told her, once the specialists are done with me, its just going to be you and me monitoring this. She has been wonderful and she also listens for as long as it takes. She takes care of most of my prescriptions, gyno check ups and biopsies; all of my results have always gone to her. Last time I saw her she said: I keep getting all of these results that tell me a lot but, but none can tell me how my patient is doing. How are YOU doing?? She is the one who reminds me 10x more women die of heart disease than breast cancer as she monitors lipids, weight and bp.

    She is a valuable member of my medical and my breast cancer team. Working with her to develop a survivorship plan is a great idea.

    Thanks for another great post.

    1. Jane, It’s surprising how a person’s list of specialists can grow isn’t it? I haven’t even listed all mine out. Not sure I want to. I’m so glad you have found a terrific PCP too. I have a whole new appreciation for mine. I really do. Thanks so much for reading and taking time to comment too.

    1. Mae, I know, right? A survivorship plan/program is now something that’s being implemented more often, especially in the larger cancer centers. Sadly, it will likely take a while to catch on across the board. It’s sorely needed. Thank you for reading and commenting.

  3. Nancy, I’m so glad your PCP is a great match for you! This is so important. What I really like is that she and you are working together with the same goal in mind: to take care of your health. I’m glad she’s a great listener; that’s part of the mark of a great doctor.

    I had a wonderful PCP for 10+ years, and she worked tirelessly to get me to the right specialists when the cancer crap hit the fan. She was a great listener and PERFECT. But due to changes in hospital affiliation, I could not use her anymore and was broken hearted. I now have another PCP who is getting to know me and vice-versa. I love her; she’s a great listener and seems highly competent.

    Thank you for a great post, Nancy!

    1. Beth, I am very grateful that my PCP and I are a good fit. She has been a great listener and really seems to have a good grasp of the big picture regarding all my issues. Too bad you had to part ways with your previous PCP, but I’m glad you are finding your new one to be good as well. Their role is really important. I have a whole new respect for PCPs. Thanks for reading and sharing.

  4. Nancy, I’m so glad you have a good PCP. I feel like I often do a lot of the educating when I see mine, but the thing is that we are old friends, he is willing to be educated, and his wife had breast cancer so he totally gets it. He was the one who actually helped me when I was suffering so horribly from post-treatment side effects — not my cancer docs. In the scheme of things, it is the PCP who appropriately should be this person who really looks after us post-treatment, especially over the long term, which is why it is so crucial that oncologists pass off detailed notes & a survivorship plan. We have a long way to go on making that a consistent protocol. And not all PCPs are good listeners…

    Important subject. Kathi

    1. Kathi, I’m glad you have a PCP who totally gets it. I’m not sure the entire “burden” for looking after us should be with PCPs. I tend to think oncologists need to play a bigger role here as well. Regardless, you’re so right – we have a long way to go on many fronts here. Thanks so much for sharing your thoughts on this. It is an important subject.

  5. She sound wonderfully compassionate. Even if she doesn’t need to give you permission, just saying that helps ease the decision, eh? Honestly, I’ve never really considered going to my family doctor with these cancer-related issues. Hmm, food for thought. ~Catherine

    1. Catherine, Compassionate validation is a huge part of a good patient/doctor relationship I believe, but of course, I don’t want mindless head nodding, agreement and patronizing either. There’s a huge difference. Good luck with all your upcoming appointments, Catherine. You are in my thoughts.

  6. Survivorship is NOT an easy path by any stretch of the imagination, yet each and every one of us NEEDS to not only be heard and validated, but we also NEED to begin to view ourselves as individuals who are WELL people. THIS is what will translate into each of us being more than cancer patients.

    Nancy, thank you for your blog, for the dialogue your stimulate, and for the thought you provoke in my mind and the minds of so many with each and every post.

    Much Love

    1. Stephanie, Survivorship is far from an easy path that’s for sure. Thanks for reading, sharing your thoughts and for the kind words.

    1. Coffeemommy, I am pretty happy with my PCP and I feel lucky to have her on my team. Maybe the fact that I’ve had so many oncologists makes me appreciate her even more. Thank you for your support! Hugs back.

  7. When I finished treatment they gave me a book about survivorship. I thought it would be positive and happy and instead it was very depressing, but looking back at it now it really covered the ups and the downs of survivorship. I love your idea of a plan for survivorship. A plan would be great.

    I love my PCP. I am spending a lot of time with her lately, but she has been my doctor since I was 12 years old and she listens to me, so I drive 40 minutes to go see her. She was the one who ordered the tests that diagnosed my cancer and I appreciate her very much.

    I also have a million specialists. Crazy to be 33 and take the number of medications that I do and have as many doctors as I do. 🙂

    1. Mandi, At least you received a book about survivorship. That’s something. It’s such a neglected area IMO. I’m glad you love your PCP too. I just saw mine again yesterday. More issues to take care of… And yes, it is crazy to be 33 and have so many meds and so many docs… Thank you for reading and commenting.

  8. I can’t say anything wonderful about my PCP. She’s okay. My first oncologist was amazing and I mourned when she moved to another state. She was a great listener and she started with a plan for me, including me, etc. Can’t say the same for the new oncologist. But where your article really hits me is that I have acquired 2 new specialists after having a stroke a month ago. One is kind. The other makes my skin crawl. She wants all these tests and I went to hear not having psyched myself up for anything like that. Get her to do the TEE that the neurologist recommended and be done with it. instead she had me doing a 2 week heart monitor, followed by the TEE and now is talking about inserting something like a port to keep track of my heart’s rythm for 3-4 more years! And during the appointment it became apparent that she hadn’t even read my medical history because she called me ‘lucky’ because only – ONLY! – my sight was weakened by the stroke. Personal interactions to doctors is everything to me. It is lucky to find doctors you can relate to, and that listen to you. Thanks again for a wonderful piece.

  9. Yes!! This is my experience as well.
    So many doctors are in their silos and don’t venture out. My PCP (the first one I’ve really had since I had a pediatrician) looks at me as a whole person, in a different way than my palliative doc. She helps me see where she fits in and she offers to interface directly with my other doctors when things get complicated or she sees something different. Such a great addition to my ever growing team. ❤️

    1. Abigail, I’m glad you have a PCP you can rely on to see the big picture too. She sounds pretty wonderful. Thank you for sharing about her.

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