The Interview Video Transcript

 

Interpersonal Communication And Relationship Enhancement (I*CARE)
Crossroads
The Interview
Time: 7:28

 

Doctor:
Hello Mrs. Simpson.

Mrs. Simpson:
Good afternoon.

Doctor:
Come in and make yourself comfortable. My nurse Dorothy was telling me you've had this back pain for the last couple of weeks...

Mrs. Simpson:
Yes.

Doctor:
...and that's why we did the bone scan.

Mrs. Simpson:
Right.

Doctor:
First of all, tell me what the pain was actually like from your point of view.

Mrs. Simpson:
The pain?

Doctor:
Yeah.

Mrs. Simpson:
Well, I don't know. I mean it wasn't excruciating.

Doctor:
Not excruciating, okay.

Mrs. Simpson:
But it wouldn't go away. So that had me very worried because as you know my grandmother who died of breast cancer, that's how the recurrence started. And even though that was a long time ago I mean I'm still concerned.

Doctor:
So you were really worried about it.

Mrs. Simpson:
I still am worried about it.

Doctor:
I understood. Maybe it's best if I just tell you what the bone scan shows.

Mrs. Simpson:
Yes please.

Doctor:
Is that okay with you?

Mrs. Simpson:
Well that's what I'm here for.

Doctor:
Of course you are. The bone scan unfortunately shows that the breast cancer has come back. It's recurred.

Mrs. Simpson:
What?

Doctor:
I'm sorry to say that. It's come back. It's metastasized and spread.

Mrs. Simpson:
What are you saying?

Doctor:
I'm saying that that's the cause of your back pain. That's why your back was hurting because the breast cancer has come back into the bones.

Mrs. Simpson:
It's come back? Are you sure?

[ Music ]

Doctor:
It's a big shock. I realize it's a very big shock indeed.

Mrs. Simpson:
Oh my God.

Doctor:
Unfortunately that's what happened and unfortunately we are sure because the way that it's showing on the bone scan shows that this is characteristic of the way breast cancer spreads. That's very overwhelming for you isn't it?

Mrs. Simpson:
Are you sure?

Doctor:
Yes, unfortunately I am sure. And I'm very aware that you're hearing that is -- this is not what you wanted to hear at all is it?

Mrs. Simpson:
No, I don't think anybody wants to hear that. To be frank, I mean there was a small part of me...

Doctor:
Yeah?

Mrs. Simpson:
...that was sort of expecting it.

Doctor:
So a part of you was expecting it. I understand what you're saying. I mean maybe it would help if I went ahead and just talked about the plan for the treatment. Would that be a good thing to do?

Mrs. Simpson:
You can cure this right? I mean even if the treatment is really nasty like before, I mean you're going to be able to take care of this right?

Doctor:
I wish I could say we could cure it. In the sense that you're using the word - and this is also very difficult to hear - we can't cure it in the sense of abolishing...

Mrs. Simpson:
What do you mean you can't cure it?

Doctor:
Unfortunately that's not possible.

Mrs. Simpson:
You can't cure this?

Doctor:
It's very difficult...

Mrs. Simpson:
In this day and age you can't cure this? Oh my God.

[ Music ]

Doctor:
I know that sounds awful and it feels terrible to you. I realize it's very disappointing and overwhelming and all off those things, but actually it isn't anyway possible to cure this kind of a situation. Control is what we can do. But it's not actually possible to cure it.

Mrs. Simpson:
I'm just trying to get a grip on what you're telling me.

Doctor:
And that's very difficult isn't it?

Mrs. Simpson:
Yes.

Doctor:
It's not easy.

Mrs. Simpson:
Yes. And then there's this same thought going over and over in my mind right now.

Doctor:
Go ahead. Tell me what's going through your mind.

Mrs. Simpson:
I mean if the cancer's come back after all that treatment...

Doctor:
Yeah.

Mrs. Simpson:
...and after all this time, then really all of that chemo and all of that hormone treatment it really just wasn't worth it, was it?

[ Music ]

Doctor:
I know that's very disappointing.

Mrs. Simpson:
Disappointing?

Doctor:
Yes, I do understand how disappointing it is. But actually the treatment did do something. Perhaps I can try to explain that. Can I try to explain it? Your breast cancer had these receptors, progesterone receptors, which means that there was a high chance that it was going to respond for a time at the worst you know to chemo and then hormone treatment. And it is very likely that that treatment did do something. If it had been negative the receptors, it wouldn't have done it. But it was positive and it is almost certain - though we'll never know for certain - never know for sure that actually the treatment did something to delay the recurrence, the cancer coming back. And also, therefore there is a high chance of the cancer responding to more hormone treatment at this point now. Does that make sense?

Mrs. Simpson:
I guess.

Doctor:
I mean in general breast cancers that have got these hormone receptors do behave less aggressively than the ones that don't. And if there is a recurrence, it will happen later. Do you follow me?

Mrs. Simpson:
So what are you saying?

Doctor:
What I'm saying is that right now we both wish - obviously we both wish - that this hadn't come back.

Mrs. Simpson:
Yes.

Doctor:
But it's come back after many years and because of the way it was originally -- the primary cancer when it originally presented, there is a good chance that it is controllable by hormone treatment now.

Mrs. Simpson:
I mean I guess that makes some sense. You know it's just been a really terrible few weeks.

Doctor:
Tell me.

Mrs. Simpson:
You know, the back pain it was bad enough. And then Dr. Stone, my own family doctor...

Doctor:
Oh your family doctor. Go ahead.

Mrs. Simpson:
Yes, he didn't even take me seriously. I mean he told me it was a muscle strain. A muscle strain. And it is bone cancer now.

Doctor:
Obviously that's very upsetting to you.

Mrs. Simpson:
You know, you know what? I'm going to sue him.

[ Music ]

Doctor:
You're obviously feeling extremely angry and I have to say that in these circumstances if a cancer comes back, most people feel angry and I think we all do. We can't -- it's very difficult to sort of get a hold of...

Mrs. Simpson:
So what you're trying to tell me is that what I'm feeling is normal?

Doctor:
In these very abnormal circumstances what I'm telling you is exactly right. That that's normal. One feels one wants to blame. In many respects, perhaps it would help both of us - it would help you and help me - if I actually talked about how we're going to deal with this situation. As I said to you, there's a high chance that it will respond to hormone therapy. So what we'll do is we'll do some blood tests including the CEA and so that we can watch over the situation. Start the hormone therapy and we have a high chance of seeing the cancer gradually...

 

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