Are doctors supposed to tell you if they suspect you have cancer?

[Slidesandsandpits]

My Mum has had some test results back that could indicate cancer- raised blood calcium on two occasions that isn’t caused by her parathyroid gland. She’s also lost about a stone and half quite quickly and had a DVT, but about 5 weeks ago she became very unwell with a bad chest infection and ate basically nothing for about a fortnight, then hurt her knee and wore a leg brace continually/barely moved her leg for about 4 days. This was before the DVT, so I imagine there is a chance that could have caused it.

She’s been googling (as we all have, to be honest) and she’s become fairly convinced that she’s got cancer and that is the cause of the DVT, the weight loss and the high calcium. I’m aware it could be, but apparently none of the doctors she’s seen have mentioned cancer to her. Are they not supposed to tell you if they think that’s what it might be? I have been referred under the 2WW before and the GP honestly told me that it could be cancer, but that wasn’t what she thought it was.

She has had a CT scan, so we are waiting for the results of that now. I am very scared, so any advice would be much appreciated.

Family member was told immediately that it was a possibility as soon as a concerning blood result came back, even though it wasn't confirmed for a few weeks more with a lot more tests.

So sorry you're going through this.

I don't think GPs would necessarily be qualified to say if it is cancer or not, but they have reasons to expect that it possibly could be then they should be referrring it on the 2WW pathway.

I suspect based on what you've said, that the GP doesn't think she's got cancer, and that's why they've not said anything. Sometimes it can be pretty obvious and that's a good time to tell the patient - maybe a very visible lump with pain, a clearly abnormal mole, etc. It's also helpful to encourage a patient to engage, if maybe they've not fully realised the seriousness of their symptoms.

But it sounds like your mum's got a lot of things going on which point to many possible causes and cancer is only one of them and probably one of the less likely. The scan is to confirm that, and once she's got the results back, she can start working on a treatment plan if necessary. I imagine she's already received treatment for the DVT and the chest infection?

Apologies, these are hospital doctors (I’m not sure what sort) rather than her GP. She went in to hospital on a Friday to have an ultrasound to have the DVT confirmed, and that’s when they told her about the high calcium. She was told to drink plenty over the weekend in case it was dehydration, but she had more blood tests done on the Monday which confirmed high calcium but not a parathyroid issue.

No not always, my MIL was told she had a black spot on her lungs (had a chest infection) but they said nout to worry about come back in 4 weeks for another xray.
ended up in a&e a week later, had another scan told immediately it was cancer.
GPs are shit bags.

@SpiceGirlsNeedAComeBackGPs aren’t shitbags.

the hospital doctors might not immediately mention cancer whilst it is on a list of possible diagnoses undergoing investigation

sorry that your mum and your family going through this - you could ask to have a family meeting with your mum and the consultant, mentioning that ahe is concerned about cancer.

My experience with my mum was high calcium which wasn't parathyroid.
I googled and knew it was a high possibility about 3 weeks before they told my mum.
My mum was admitted for tests based on her decline, the calcium level and to do various tests.
They struggle for 2 weeks to get her calcium down.
But at that point cancer wasn't mentioned to anyone.

I was in shock knowing it could be but because nothing was suggested I kept quiet of course.
She had alot of other conditions which had to be taken into consideration both in treating, and what tests were safe to do.
It was very frustrating, then she got COVID, twice so that prohibited being moved to other departments for scans.

My mum was diagnosed with cancer I won't go into details here as you asked a specific thing.
In our case they didn't tell mum until a few weeks in hospital.

We weren’t told and it wasn’t even hinted at, with similar symptoms, until the scan results came back.

This was GP. A and E drs and consultant.

There are many possibilities. They clearly wish to exclude cancer by doing a CT scan. In my experience patients don’t thank you if you raise the possibility of cancer and it turns out not to be. It can understandably cause a lot of panic/worry. Some people will google/question and worry regardless. But some will not and why cause worry until you know?

This seems a risky strategy. if the patient gets the impression that it’s probably nothing serious then for all you know they may decide not to go for the extra tests and just wait for the body to heal itself. Some people are busy and not too good at prioritizing their own health unfortunately.

surely it’s always better to let them know?! it’s their body and their life after all.

There are other things that can cause high calcium levels. Can she log into her NHS app? Often, test results are on there before they’re given to you. Can you ring the secretary of the doctor who requested the tests?

GP's are shitbags - If you really believe that does that imply you won't be asking any for medical help in the future then?
I'm sure my d wouldn't miss peeps who slag doctors off although she is obliged to provide care in financially tight times regardless. She to put up with abuse on a daily basis because she's not allowed to prescribe certain drugs due to expense and explain for the 20th time why she can't give antibotics for certain things.
It's some of the general public who are the shit bags.

@Tcateh Thank you for your reply. I’m really sorry to hear about your mum’s diagnosis. Would you mind me asking what type of cancer it was? I completely appreciate if you’d rather not share though.
I don’t think my mum’s levels can be high enough to be causing a problem in themselves as they’ve not mentioned anything about trying to bring them down, other than telling her to drink plenty. I could be wrong though, unfortunately she didn’t ask what the numbers were.

@similarminimer Thank you. I have suggested to mum that she makes an appointment with her GP to tell them that she’s worried it’s cancer and to ask if that’s what they suspect it is, what was the CT scan specifically looking for etc but she doesn’t want to at the moment.

@itsmeecathy Thank you for your reply. I’m sorry, that must have come as a horrible shock.

I’m taking some small comfort that the chest X-ray she had done on the same day as the ultrasound came back clear, and she’s had a mammogram in the last 2 years that also came back clear. That might be a bit naive of me though, I don’t know.

Sorry about your MIL, @SpiceGirlsNeedAComeBack. Our GPs are generally very good, but I appreciate that not everyone has the same experience.

I think now doctors in general are so worried about claims, blame etc that until they have an actual diagnosis they don’t like to comment or suggest either way.

Quite frustrating as the patient though! I had issues in my last pregnancy that the hospital were very obviously concerned about, urgently sent to hospital for scans/bloods etc, not a single person including the sonographer would tell me what they thought might be wrong, it was just “lets do these tests and see what the outcome is” they were looking for something, obviously, because the scan was FOR something but nobody would say what that something was.

My gran has recently had a very similar experience with a cancer scare, until they have a diagnosis they are unwilling to even say the word.

@Slidesandsandpits Raised calcium can be caused by dehydration. Did they tell her how much to drink over the weekend? And what kind of fluid to drink? One persons thoughts of how much is plenty can be very different to another’s, and to what is actually expected/required. A relative of mine was told to drink plenty to try to keep her blood pressure up as it kept dropping - she said she does drink plenty .. her ‘plenty’ was less than 600ml of water per day.

I wouldn’t tell them it’s nothing serious. I would tell them we’re taking their symptoms seriously and doing a whole body scan to rule out anything sinister. But I wouldn’t say ‘I suspect you have cancer’ as more often than not they don’t.

I think they said to aim for 2-3 litres, but she did say that she didn’t feel she quite drank enough. I know she did get pretty dehydrated when she had the chest infection, but I don’t know the long term effects of that.

It would be helpful to know whether the levels had gone down at all for her trying to drink more over the weekend, but I don’t know whether they had or not. She said the doctor did say it could still be dehydration, but from the tone of his voice it didn’t sound likely.

We can all interpret tones of voices and facial expressions differently, so I probably wouldn’t gauge on that to be honest. Its fluid intake really does need to be as they said, the results will be very different if it’s caused by dehydration. Was her ‘not quite enough’ almost the full amount or nowhere near?

Posted too soon 🤦‍♀️
I understand how difficult it is to drink 2-3 litres per day, even more so for older people to be honest. Hopefully you’ll have some answers soon x

I don’t know what they’re meant to do, but the people I am close to who were told were told when they were told they had it. First hint/ incling/ mention. All absolutely shocked🙁

I’m honestly not sure how much she was drinking, to be honest. I feel bad mentioning the other potential causes now, because I don’t want to get her hopes up too much by pointing out the other things it could be.

She’s not even 60 yet, so not an older person at all. Thank you, hopefully we hear something soon and it’s good news x

Hi, I have no idea why they spent so long trying to get the levels down when they did have a scan to show a big spot on the lung, but from reading maybe that's just something they could probably actively do during the whole testing and controlling journey.

My dear mum had non Hodgkin's lymphoma stage 4.

From diagnosis to her passing took 3 months.
She was overall too ill for chemo and declined trying it.
Xxx

She would be told she was being referred under the 2 week cancer pathway by the GP. However, at the level of hospital care, it’s not quite as simple as suspecting it’s cancer or not. With the GP it’s just ticking a box for an urgent referral and 90% of those are not cancer. It sounds like she has a number of ongoing issues which paint a possibly complex picture. I don’t think it’s obvious it’s possible cancer, but certainly it’s one possible option they might explore.

They won’t keep the fact they suspect cancer from you, but it sounds like too early in the investigations to know what they might be looking at. However, when you next see the hospital consultant, just ask what possible causes they are exploring.