A perceived or real delay in arriving at the diagnosis of advanced cancer can cause distress that becomes an obstacle to Healthy Survivorship.
Patients may play a role in the delay, if they delay reporting or following up on worrisome symptoms because they...
- don't know the symptom is worrisome
- ignore the potential problem
- feel too busy to deal with health issues
- misunderstand their instructions regarding follow-up
- worry about the financial impact of finding a problem
- don't want to deal with the medical system
- fear inviting trouble (i.e., magical thinking)
For patients who are having trouble letting go of guilt, embarrassment, anger or shame due to their role in a delayed diagnosis, I hope this handout helps: If Patients Feel Guilty.
In cases where clinicians may have played a role in delayed diagnoses, different thoughts and feelings are involved, so patients need to take a different path to letting go, as I'll discuss in a future post.
I purposely didn't include false negatives, i.e., correctly executed and interpreted tests that miss disease. Few tests are 100% sensitive (i.e., no false negatives). I also didn't include situations where the best decisions were made based on available information, but diagnoses made along the way subsequently proved to be incorrect when further tests were done and/or the disease progressed.