CEA Script:

Catharsis:

a. What came to your mind when you first noticed the enlargement on your neck?
a. At first I was embarrassed at how it made me look. But then later on as I kept thinking
about it I thought, what if it’s serious and that I might die?
b. What did you feel when these thoughts entered your mind?
a. At first was embarrassment but now it’s mostly fear. I hope it is nothing serious.
c. What consequences of the illness make you feel this way the most?
a. Like I said, it is very noticeable and I don’t like the way people look at me and I am
embarrassed. But, I am also afraid that this might be a tumor and that this may kill me.

Me: So to clarify, the two emotions you are feeling right now is embarrassment and fear. You fear that
this might be a very serious illness and that it may kill you and that you are also embarrassed that
people might gossip about you or give you weird looks. Am I correct?

Education:

Me: While it is probable, it is highly unlikely that you will not die in your current state right now
especially since you are not experiencing symptoms. If it is a tumor then it cannot immediately kill you
since it takes time to grow and you’ll be experiencing symptoms by then. I understand you have
cosmetic concerns and it is good you immediately sought help, the sooner we treat this, the sooner your
life can get back to normal. Sir currently, we cannot give you an accurate diagnosis yet of your illness
especially since you are not feeling any symptoms related to it. The enlargement on your neck be a lot of
things, it can be an infection, it can be a tumor, it can be a cyst, and etc. However we cannot provide
proper treatment without knowing what it is, so we need to do some diagnostic tests.

Action:

-----Management options and possible diagnostics

Me: What we can do is to do a Fine Needle Aspiration biopsy. It will involve you lying down while a
needle is inserted in your neck. It is similar to the one done in blood tests but this time they will use a
thinner needle. Along with this an ultrasound will also be done to help guide the needle. We need to do
this to determine if this is actually a tumor and whether this is benign or malignant. Benign is harmless
and malignant is harmful. Your treatment will depend on the findings of the test.