How to handle thoughtless comment from P.A.

christina0001 · October 2012

I went for my herceptin treatment today and was seen by the new physician assistant. She's only seen me once before. She is young and fresh out of school. Well today she chats with me about her engagement, and asks if I have children, and I say no. Then she asks if my husband and I plan on having children in the near future, and my heart just broke. The hardest part of having cancer for me is that DH and I were planning on having children next year. Well, I have not had a period since my first chemo treatment back in February, and I am supposed to be taking tamoxifen for the next five years. So NO I will not be having children in the near future, but I was so upset, I could not speak. She goes on to babble about how she's never met my DH but she is sure we would have the cutest babies!

I held it together until she was done with me and left. I then proceeded to cry through the rest of my treatment, cried all the way out to my car, and have been crying on and off since. I cannot believe that my own healthcare provider could say something so thoughtlessly insensitive. I feel like I need to do something...would it be a good idea to maybe write her a letter explaining how much what she said hurt me? And encourage her to have a little more sensitivity when talking about fertility and reproductive issues with young, female patients?

Am I wrong in assuming that she should be aware of the fact that chemo and tamoxifen have major effects on fertility?

Leah_S · October 2012

Oh, Christina, I'm so sorry this happened to you! Absolutely you should write her a letter! I am appalled that an onc's PA wouldn't know this info, and would be so insensitive when dealing with patients.

I also think you should let your onc know.

Sending you lots of love.

Leah

rozem · October 2012

ABSOLUTELY write her a letter and speak to your onc, I had a similar situation happen and i went to the head of breast oncology at our cancer centre. She was very gracious and basically said that they are all human and make mistakes, but like any "business" the mistakes need to be discussed and a plan of action to remedy it. And yes, she should be fully aware of the effects of tamox/meno on fertility she is a PA!

summergirl1 · October 2012

Christina, I am so sorry you had to deal with this, people can be so insensitive and dont think when they say stuff like this and how much it hurts, I am a yr out since my TX and found the worst part of going through Cancer was peoples ignorance, , I was devastated to lose my long thick wavy hair, and tried so hard to be positive wearing the stupid wig but it was so hard as someone would always make me upset with their stupidity, even the day I got the All Clear and went out to celebrate with my OH a dear friend came up to me and said "thats great news but know you just need to get rid of that" as she points to my wig, I went from being extremely happy to a blubbering mess and ended up leaving and coming home and wouldnt go out for weeks after that, I know its not the same as what you are going through but people should really think before they say things and I do think you should write her a letter so she doesnt do that to someone else going through what you are going through.

hugs to you xx

mgdsmc · October 2012

I'm so sad this happened to you. I'm sure she was just making small talk and looking at your age. I'm not sure how old you are but maybe she meant after tamoxifen and trying to be encouraging.

As far as writing a letter you could do that but will be seen as a complaint (which it should be) and not as constructive as a face to face. Her seeing how much she hurt and upset you will have an impacted and help her to understand why you were upset. I agree she should know better but you said it yourself she is new. I bet she will always remember you throughout her career. There is no wrong way to handle this just eanted to give you another option.

Glad you are feeling a little better

ali68 · October 2012

Christina, so sorry you went through that maybe she thought you would have children. I have read younger woman like you get there periods backs while taking Tamoxifen. I have had a bit of spotting but not a period, I don't think mine will come back as I'm 44.

Even my onc said to me would I want more children WTF, I had sterilisation 13 yrs ago.

(((Hugs))))

ali68 · October 2012

Have you seen the thread on here, young woman with tamoxifen and periods.

Have a read.

camillegal · October 2012

Christina that had to hurt u on so many levels and am truly sorry it was so hard on u. U did say she was young but that was still uncalled for she should have known better and personally I would talk to her but if that's not comfortable for you then yes write her and let her know how u felt for the rest of the day. There's nothing wrong with telling u'r onc, but I don't think I would. She should learn just by u talking to her. but again there is no wrong way to handle it for u.

Racy · October 2012

Is she the 'receptionist'? I would write or speak to her employer. It may be a training issue. I would mot approach her directly as I don't see you as 'equals' in this relationship.

Sorry you had that experience.

christina0001 · October 2012

Yes you can menstruate while taking tamoxifen but you are not supposed to get pregnant. Tamoxifen increases the risk of birth defects and women are supposed to use birth control to prevent pregnancy when taking tamoxifen.

No, not a receptionist, a physician's assistant! I don't know how it works in Australia but that is more skilled and trained than a nurse but not quite a doctor. I would not have been so upset if it had been the receptionist, because a receptionist would not know my situation, but I expect my oncologist's P.A. to know my situation.

Anyway thanks for all the support ladies. It really helps. Cried to DH, my mother and a good friend last night about it too, so now I am feeling better. I wrote the P.A. a card telling her that I know she was just making conversation, but her asking me that really hurt me, and I asked her to please be more careful when bringing up reproductive/fertility issues to us younger cancer patients. I tried to not be mean at all, that is not my intention, I think she was just being thoughtless and maybe she does not know a lot about breast cancer yet. I am not going to complain to my onc. I adore him but he has a well-known reputation for being very hard on his staff and I don't think the P.A. deserves that. I think if I give her a note explaining how I felt, I think that will be enough for her to be more aware of this issue for us younger patients.

Leah_S · October 2012

Christine, I think you dealt with the situation with dignity and consideration.

I am impressed with how you handled all the aspects of this.

Leah

Cindy-Rose · October 2012

Christina,

I think that you handled that perfectly. I don't think that she meant to upset you in any way however she has to learn what not to say or she'll eventually say something to someone that could cause a lot of damage. I bet it felt good for you to write it all out. Good for you! Wink I would mention it to her when you see her just to make sure that she understands where you are coming from. Your feelings are important and you should be able to trust her which is difficult to do if you have an unresolved issue.

All my love,

cin

ali68 · October 2012

Christina, we have been friends a long time and I hope I haven't upset you. All I mean't was younger woman come off the Tamoxifen to have a baby then go back on it.

You can shout at me if you want.

christina0001 · October 2012

No, you did not upset me Ali. Thanks for all the support. I felt a little upset again this morning but I am moving past it. Nothing is ever easy with this stuff.

How to handle thoughtless comment from P.A.

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