Cancer. It’s hard to find a scarier word. The mere mention of it can evoke waves of panic and frightening images of protracted illness, painful suffering, and a long, lingering death. If you have just diagnosed cancer in one of your patients telling the owners about it can be stressful and even tricky. You may find yourself worrying, “how will my client react?” “What should I do if the client starts to cry?” “What do I say if the client becomes furious with me?”

The truth is that clients can, and will experience a whole gamut of intense emotions and express them in different ways and at different times. Many veterinarians get stressed and feel ineffectual in helping their clients in these situations. This stress can also affect your entire veterinary team.

To Treat, or To Not Treat?

Every veterinarian is familiar with, “Doctor, what would you do if this was your dog?” Obviously, you cannot tell people whether or not they should treat their pet’s cancer but this question does provide you with an opportunity to empathize and support your clients (“Mrs. Wilkinson, if Roscoe were my dog, I would be feeling just as worried and confused as you are. While there are no magic answers here, it’s important for you to know that I will support you as best as I can no matter what you decide to do.”

Communication Strategies. Talking with clients about cancer and possible treatments can be difficult and time consuming. There’s often complex medical terminology that clients may find confusing and intimidating. Their emotions can also interfere with their ability to understand the facts. A few strategies to try include:

• Remind clients that cancer is not an immediate death sentence. Most people have been affected by cancer in some form or another. They all have different pre-conceived notions of what cancer is based upon those experiences. Explain to your clients that many types of cancer treatment in pets rarely are the same as the treatment in humans. Explain that the pet’s overall health, the type and location of the cancer, and the progression of the cancer can determine how their pet may respond.
• Educate your clients about anticipatory grief. Anticipatory grief refers to the sadness and painful emotions that people often feel before death has This type of grief comes when the mind tries to “prepare” the person for upcoming pain. Many describe this as “hoping for the best” while trying to “prepare for the worst.” Let clients know it’s normal to experience these emotions.
• Prepare and give client hand-outs and educational brochures. Cyclophosphamide and Doxorubicin may be words you understand, but most of your clients won’t. Some pet owners have little knowledge about cancer treatment and to make matters worse, clients who are scared, stressed, or upset have even more difficulty digesting complex information. Make sure that everything is written down and explained in simple jargon.
• Give the clients as much time as they need to decide about treatment (within reasonable medical limits). Removing the time pressure on your clients will help them to concentrate on the facts and hand and can even accelerate the decisions-making process.
• Talk with your clients about quality of life issues. You will need to be an advocate for your patient so emphasizing their condition and quality of life is essential. Remind clients that every situation is unique and just because they can provide treatment for their pet; it doesn’t necessarily mean that they should.
• Discuss financial implications with your clients. It may not seem fair that clients must often make decisions about treatment based on finances. However, living in the real world requires them to do so. Ask them to consider their financial resources and expenses that may come up over time.
• Refer clients to other pet owners who have dealt with cancer. Ask clients that have gone through cancer treatment if they’d be willing to talk with other clients about their experiences. Advise your client to ask direct questions such as, “if they chose treatment for their pet, would they do it again?”What, if anything, do they regret? “
• Encourage your clients to talk openly with family, friends, and anyone else who might be supportive. Family and friends can often provide valuable support and help with making decisions and pursuing treatments. If a client decides to move forward with a treatment, ask them to consider how this may affect their family as a whole.
• Let clients know the importance of self-care. Many pet owners dealing with cancer treatment can become overwhelmed, exhausted, and significantly stressed out. Remind clients that self-care is not only important for them, but also for their pet (they can’t help their pet is they are exhausted or perhaps sick).
• Encourage open-ended communication. Encourage clients to communicate with you regularly and to never hesitate to ask you and your staff questions or voice their concerns. This will reassure them that you will support and stay with them throughout this entire process.