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Essential
Skin
Patient Communication Flow Chart
**For this flow chart, the patient will be positive for skin cancer (melanoma). The first part of the page will show the basic flow of what the conversation should look like, and the other half will explain more to each bubble**
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Bubble #1
Tell the patient that they are positive for skin cancer
Bubble #2
The patient breaks down and does not know what to do
Bubble #3
COmfort them/ask if they need to be alone and make sure they are okay until you give any further instructions
Bubble #4
Once calmed down, explain what they should expect in the future treatment-wise
Bubble #5
The patient asks more questions about what they should do and how to handle things
Bubble #6
Answer patient's question(s) properly and make sure that they understand everything thoroughly
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Bubble #1: The patient needs to know that they are positive for melanoma. When working in a medical profession, you absolutely should not try to beat around the bush and make the situation sound lighter than it actually is. Doing that can give the patient a sense of false hope. Yes, most skin cancer is extremely treatable if detected early, but telling them that when they can have something really serious will not just hurt them, but it can also hurt you and your career. Your sentence should come out as shown below:
"Ms./Mr./Mrs. [insert name], I am sorry to inform you that you have tested positive for melanoma, a form of skin cancer."
After telling them this, make sure to give all possible reasons and proof as to why they are positive. The ABCDE's of skin cancer are a good thing to remind patients of. These letters stand for:
- A - Asymmetry- Does the mole have an irregular shape?
- B - Border- Is the edge of the mole rough and irregular-looking
- C - Color- Does the mole have different colored spots/uneven shading?
- D - Diameter- Is the size of the mole larger than 1/4 of an inch (about the size of a pencil eraser)
- E - Elevation/Evolution- Does the mole seem to be changing is shape/size/texture?
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Bubble #2 and #3: The patient can have a few reactions, and breaking down is one of them. People can be hard to cheer up, so as a health worker, you need to understand how people can hurt not just physically, but emotionally as well. High amounts of stress can tamper with test results (such as heart rate and blood pressure) that are needed for the final results. When they start freaking out afterwards is a different story though. When someone breaks down, they can not seem to focus. Things become blurry and their brain kind of sends messages to the person that these waves of emotion are hard to cope with, these emotions are so unbearable. It is up to you to help this person out of these feelings of hopelessness and into feelings of courage. Something that you can do to cheer the patient/patient's family up is: When things have cleared up, ask the patient about their lives; how many pets do they have? Hobbies? This shows the patient/family that they are not just another patient, but they have importance and you care for them like a doctor should.
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Bubble #4, #5, and #6: This is the point when the patient needs to know what they are supposed to do. The whole reason they came to the dermatologist (after hearing about if they tested positive or not) is to get to this point. They now need to know what they should do by means of taking care of themselves, and what will help them successfully fight the battle against cancer. There are medications/treatments that a cancer patient should look into to fulfill their wishes of healing quickly. Here are some common treatments and medication that are useful for fighting melanoma:
Medication(s):
-Interferon Alfa-2b
-Vemurafenib
-Dabrafenib
Treatment(s):
-Radiation Therapy - X-rays and other high-energy rays are used to kill abnormal cells.
-Mohs Surgery - Gradually removing layers of skin until as the melanoma is removed.
-Skin Grafting - The procedure of taking skin from one part of the body and transplanting it on another part of the body.
-Wide Local Excision - Surgically removing the affected part of the skin along with a small amount of the margin around it.
When telling them these things and explaining more upon them, they will either get it, or ask more to actually understand what all these long words mean. It is crucial that they understand what the medications and treatments mean and what they do. They can really hurt themselves from misinterpretation of what the medication does/how much needs to be taken, and that can really hurt your career. Make sure that you explain! The medical field is not a field that you can do very minimal on.
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Radiation Therapy
Mohs Surgery
Wide Local Excision
Skin Grafting
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