Would you complain about being told to expect a cancer diagnosis when you don’t?

[BuzzyBallz]

Context- I am a surgeon. My husband is a judge and we have a very busy life. Being tired is our default. However DH was remarkably more tired, we’re talking coming home from work early (at 5pm rather than 8) sleeping til 9, getting up having pizza and then going to bed again til 5.30)

I basically forced him to go to the drs and I wrote the e consult for him because I knew the medical words for things and how to get our gp to listen.

he submitted the e consult at 7.45 am on Monday, saw a gp at 10am. She did bloods and told him to Go home and rest.

On Tuesday morning he had a phone call from the GP saying he would hear from the national cancer centre near us, that he had an appointment for the following day, was told to not go alone and to expect ‘100% a diagnosis of lymphoma or leukaemia’

I never want to repeat those 24 hours, I saw his bloods and I knew that they were grossly abnormal so I could understand the importance of having him
seen by a haematologist.

We saw the haematologist and she said that he didn’t have cancer he had very serious glandular fever. The relief was indescribable. DH wants to send an email to the gp basically castigating them for telling him to expect a diagnosis of cancer when he didn’t have cancer? I feel like he would be a bit unreasonable to do that because his bloods were so abnormal I understand why they fast tracked him immediately, whereas his view is that he doesn’t have cancer and therefore could have been spared a horrible 24 hours where we thought he would need to re evaluate his entire career and life etc.

So am I being unreasonable to say I wouldn’t complain, because I understand why he was fast tracked whereas he thinks the emotional anguish they caused him was unreasonable. So who is being unreasonable?

Me- YANBU
DH- YABU

I’ll take it with grace if I’m unreasonable (promise)

Gratitude for the excellent service he received overall would be better than the issue of one person who did the right thing, but possibly with the wrong words.

Is it really the case that a Judge couldn’t expect to write an e-consult for a GP and have it “listened to” by a GP? That only a surgeon is capable of doing the job? I’m just a lowly construction professional, I wonder how on earth I can get a gp to listen to me?

I had similar but i did have blood in my poo. The doctor made me sit and listen as i was minimising it and she told me in no certain terms that i was ill. Turned out it wasn't cancer but i did have to have my appendix out. She was so pleased to tell me i didn't have cancer and was really suprised that i didn't from the images that were taken.

Relief was the main emotion.

I don't think you should complain.

I have been referred under the 2ww twice now, and each time they have said versions of "I can't say for certain, that's why you need more specialist investigations and tests, but I have seen this symptom/sign in people who have turned out to need treatment for malignancy and therefore im referring you under the suspected cancer pathway"

I have had to have a biopsy in which they stated they wanted to take more than originally thought as they were concerned about appearances too.

If you are referred and seen within 48 hours, and your bloods are grossly abnormal, the you're receiving the care you should in the place you should and I'd be nothing but grateful if the outcome was better than expected.

Turn it round. Your husband said he didn’t want to go to the appointment . GP says ok well it may or may not be serious. Husband doesn’t go and it turns out it was cancer. Complains then that he didn’t realise how serious it could be and would have gone if the gp had been more clear.

My father in law was told he didn’t have skin cancer when he did. I think on this instance he should count his blessings

Agree. Leave it. The GP wasn’t sure so therefore shouldn’t have mentioned cancer but just be thankful x

No. It’s mainly he is autistic (diagnosed) and will just have put ‘I feel tired’ as it’s not related to his job. Whereas I wrote Ive felt tired from x date, I have had xyz extra symptom, I believe I need abc tests (it says what do you want the surgery to do on the consult) I probably should have clarified that I apologise. His ability to communicate when it is not in his expertise is not brilliant. I can guarantee he would have just put ‘I feel more tired than usual) and skipped all the other questions.

My father was told by two consultants that he certainly had cancer. After further investigations luckily he did not.

I’m nothing but grateful for the care he received and that we had a positive outcome.

Yes it was unfortunate that those words were used, but I wouldn’t dream of a complaint

I completely agree! I think he has had absolutely brilliant care and has nothing to complain about, whereas he believes that he shouldn’t have been told it was urgent and been ‘upset unnecessarily’. I think he should be bloody grateful he doesn’t have cancer !!

For me it hinges on whether the GP actually said '100%' to expect it. I agree with PP who said giving the warning shot in advance and letting the patient know to prepare themselves for bad news is a good thing, but as a clinician yourself you must know you never make such definite statements unless you're absolutely certain and are the right person to give that news.

I’d just be so bloody grateful. Tbh - getting an appointment at a cancer centre would surely make one think they have cancer.

Honestly, I can't believe that you would even think of complaining. Your GP saw you quickly and you had 24 hours of worry before being sent to a "Cancer Centre". I'm guessing haematologist.

Many cancer patients wait for a 2 week wait, for appointments, scan results etc. They often have a diagnosis of cancer already. I'm amazed that you're medical actually.

I would gently explain how much resource will be diverted away from other (perhaps less fortunate) patients in answering his complaint and that he should be grateful he got assessed so quickly and doesn't have cancer. Poor GPs literally can't do right for some people. Was a haem malignancy on your list of differentials when you saw the results?

I have to admit I’m not sur show the vote is supposed to work, but I agree with you. From what you say your DH was not taking the situation seriously and the GO wanted to make sure he attended and probably wanted him to be prepared for bad news.

Lawyers are typically not very forgiving and don’t deal well with being told the “wrong” thing and I would expect as a judge this is further exacerbated-I am a solicitor so feel able to say this!

If nothing else please don’t kick the GP when they are down, as you know they work extremely hard and generally get a terrible rap and they turned this round amazingly, so he is fine to feel irritated but he should keep it to himself.

It's not you who was told with "100%" certainty that you had cancer so it's easy for you to say. Same to the posters saying he should be grateful. That's just bullshit.

I had something very similar done to me only I was left for over a month believing I had cancer and without any support to cope with that. It was deeply damaging and traumatic and obliterated my trust in clinicians. It is not something you just instantly shrug off and skip away from as if it didn't happen.

Someone can be relieved and traumatised at the same time. The two things are not mutually exclusive.

And the speed of his referral was not dependent on him being told he "100%" had cancer. Meeting the faster diagnosis standard does not require any patient to be told that - least of all by someone who was clearly not sufficiently knowledgeable or informed to make the determination! It was inappropriate, especially if it was over the phone.

But if she’d had been told at the GP appointment she’d still have been alone when she was told?

Advice to take someone with you to the referral appointment would have been a more tactful and less definitive way to manage expectations without the shock factor.

My feeling is that GP didn't say "You have cancer" but rather "don't be surprised if the diagnosis is cancer". That's what "100% expect" means.

In my mind, GP didn't diagnose cancer. GP advised to be fully ready for that diagnosis. GPs are damned if they do say "expect something very bad" and damned if they say "don't be too worried". In law, don't lawyers just end up vaguely saying "Dunno" which for some people is worse than being told to expect the worst, because the client ends up feeling like "I don't know WTF is happening."

Aside: there are worse diagnoses than cancer & many cancers are survivable. The obsession with "cancer!!!!" on MN is kind of weird and doesn't help .. anyone, maybe?

Exactly.

The speed of his referral is a separate point. It doesn't negate the inappropriate communication. Getting someone seen quickly is not a licence to behave unprofessionally in your interactions with the patient.

I was told cancer cells had been found. Three weeks later , the hospital decided they weren’t cancerous, but precancerous. Honestly, I felt nothing but relief!

My relative has just been told her ‘urgent’ haematology appointment will take at least 18 months. He has been very fortunate.

He couldn't say he was fine, and in his medical opinion it was more likely than not cancer. He is a human being.

It's better they fast tracked him than disregarded it. He could've had cancer. He should thank his lucky stars he found out he didn't so quickly. Thanks to the GP's actions.

So no he should not complain. Though if I was the GP I wouldn't have said 100% expect cancer. I'd have phrased as probable, not definite.

It wasn't brilliant care and the lack of empathy in your attitude is disappointing if you are patient facing yourself.

What if he had been told that over the phone and then harmed himself? Clinicians owe a duty of care to the whole patient, not just their body.

one of the things he told her was that he had a 3 day trial starting the following day so he didnt want to go to the appointment He had a referral to a cancer team within 48 hours of doing an e consult and he was complaining that it was inconvenient for him? 🤦‍♀️

Dear OP’s husband, I think you should sit down, shut up and spend some time reflecting about just how bloody lucky you’ve been. Your average patient can’t get a GP’s appointment, let alone immediate blood tests followed by an immediate referral. You’ve got all these professionals rushing you through urgently because your blood tests looked so serious, and instead of thanking your lucky stars that it’s not cancer, you’re having a tantrum because you didn’t have a very nice 24 hours? Would you have had a better 24 hours if the Dr hadn’t said that to you? If you’d just been left wondering whether your medically qualified wife was hiding her thoughts from you? Knowing that there was a reason you’d got that urgent appointment? You’ve got a second chance here in the cancer stakes. You had no nasty shocks because you would have still had that urgent referral. They told you to expect it; they prepared you for the worst and you got lucky. And now you want to cause someone all sorts of problems because they forced you to take the advantages you’d been handed?

Many years ago when I asked my consultant what he thought I had I was very abruptly told “well it’s cancer isn’t it” op 4 weeks later revealed it was a cyst. Whilst those weeks were very frightening and and times incredibly painful I was so relieved to find it wasn’t cancer but traumatised by the experience.