Nurses are often thought of as the people who help patients get better when they’re sick; they are less often thought of as the ones who become sick. However, there are, of course, times when the nurse must become the patient. In a recent article, published in Annals of Family Medicine, one nurse shared her experience with being diagnosed with metastatic breast cancer.
Mary E. Burman, Fay W. Whitney School of Nursing, University of Wyoming, Laramie, Wyoming, who has been a nurse for 40 years, said she was initially diagnosed with breast cancer in 2010, and received a metastatic breast cancer diagnosis in 2018. In sharing her experience, Burman highlighted three specific areas of importance: (1) the way clinicians give their patients bad news is important, (2) telling loved ones and colleagues the news of a cancer diagnosis is a significant challenge, and (3) patient portals are useful but can also be problematic.
After feeling a small lump in her left breast, she saw her primary care clinician (PCC), underwent a biopsy, and was initially diagnosed with stage II ductal carcinoma—a diagnosis that was changed to a stage III lobular carcinoma only after she underwent her lumpectomy. She underwent chemotherapy and radiation and was treated with tamoxifen.
After completing her treatment, all seemed fairly well. It wasn’t until June 2018 when Burman paid her PCC another visit “with achy chest wall pain that didn’t fit any diagnostic framework that I could imagine.” Unable to trace what may have been causing the pain, Burman immediately feared it may be a return of her cancer—a common worry among cancer patients with unexplainable symptoms.
Burman was ultimately diagnosed with metastatic breast cancer.
According to Burman, the greatest challenge of her new diagnosis was how to tell the news to her friends, family members, and colleagues. Living in a small community—one that she was very active and involved in—made this all the more difficult.
“With metastatic disease, I was also concerned that people would assume the worst and word would get out that I was terminally ill and not expected to live long,” she explained. Ultimately, sharing the news with others was “an emotionally draining process.”
However, the way that Burman’s PCC delivered the news was helpful because it clearly outlined the next steps looking forward.
“It made such a difference to me to be told of the new diagnosis in a comforting environment by my PCC who had a clear plan for next steps,” she explained.
It’s also important for PCCs to help patients make a decision on ow to use their patient portal. For instance, receiving the news of a diagnosis via the portal can be a less than positive experience.
“For me, the portal is very helpful as a way to keep track of appointments, laboratory results, and prescriptions and to communicate with my oncologist. However, finding out my diagnosis via the portal was repugnant to me, although may not be to others,” Burman explained.
Burman concluded her story by saying, “As a nurse of many years and a member of a family with other significant health issues, I thought I understood a lot about the experience of chronic disease. My experience with metastatic breast cancer, however, has given me a much deeper, even visceral, appreciation of living with a disease that is chronic and advanced. I hope that by sharing my experiences I can help other primary care clinicians deepen their understanding of life with metastatic cancer so they can sensitively give patients diagnostic and treatment information and support their patients as they receive that information and share it with others.”