I will not take Tamoxifen...
The situation
Mrs. Adler is being treated for breast cancer. She is a good candidate for tamoxifen. She has read things about it and begins by saying she will not take it.
Communication issues
Cancer patients are very well informed, and do a great deal of research, especially with Internet access widely available and used. Concerns about side-effects of medications need to be taken seriously and explored, since they may also lead to non-compliance in treatment.
What to watch for
It would be tempting to respond to the patient's statement with a logical explanation of why she needs to take the drug. However, further exploration of her emotional reaction reveals several significant concerns underlying her refusal which the oncologist can address through education, problem-solving and negotiation.
VIEW Vignette: I Will Not Take Tamoxifen... (8:46)
Pearls & Pitfalls: Expert Comment (2:45)
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Certain material on this Web site is available for Continuing Medical Education (AMA PRA Category 1 CreditTM in medical ethics and/or professional responsibility) through The University of Texas M. D. Anderson Cancer Center. To obtain credit you must use the “Obtaining Continuing Education Credit” link on the left. You also have the option of watching the video from this page without applying for credit.
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