Breaking bad news

Ask name of interlocutor before start of role play…

Introduction

Hello good morning/ good afternoon

Mr../ Mrs.. interlocutor’s name,

Nice to see you again, thanks for coming in today to review your lab and biopsy reports

Is there anyone in the waiting room today whom you want to remain present with you when
we discuss your reports?

I will start by asking few reasons why we did biopsy or colonoscopy or Ct scan, do you have nay
idea?

Ok

How are you symptoms? (warm up with patient)

Not improved?

Well, your test results are back and the news is not good .

1. The tests have revealed that you have …describe in medical language and then say
cancer/ malignancy etc. or
2. Unfortunately, I am concerned about the biopsy report and it has revealed that..you
have …

I am afraid, so, I realize that it has come as a shock to you. (sympathy)

Mr…, I know it is really unexpected and I am sorry to have this news today. But I want you to
know that I am here and other doctors to support you. Please let me know how you are feeling
about this.

or

My clinic and I, we are going to support you through this and we can give guarantee that we
will address your pain and all your symptoms you have in and also for your family.

I am really sorry about this. But fortunately, we have caught it early, so it can be
managed ,would you like me to tell you about treatment options that we have?
Or

The next step is meeting with a medical oncologist, cancer doctor and the general surgeon.
Most likely they will recommend following: either to remove part or entire breast. The goal is to
remove the cancer and that will be followed by radiation therapy or chemotherapy and the goal
is to kill any remaining cancer cells that may present after the surgery. I think we should focus
on keeping you comfortable.

Don’t lose hope; you still have many options available. In fact, I hope the best for you. Okey?

I can help you with the pain and the symptoms; these are the issues that arise. I am part of
team or I can arrange a social worker for you for any financial issues that arise.

My Chaplin, he can provide prayer and basic counseling for you.. Are you interested in any
services?

I can imagine how you are feeling but we are here to provide you best medical care and support
for you.

We will support you in any way that we can and no matter what happens

We will meet after one week, write down any questions that you have for me or others.

Discuss about operation, chemotherapy and radiotherapy, palliative therapy etc….

Explain in positive ways

Chemotherapy: yes, there are unpleasant side effects but there are ways to deal with them.

Palliative therapy: some patients opt for palliative care where it would be symptoms
management, we actually not necessarily trying to kill cancer but treat your symptoms that
make you more comfortable, in that case I will refer to you team of palliative care.

Surgery: try not to be worried, the doctors are very experienced and you will be in safe hands, I have
seen many patients with successful results after operation.

Do you understand so far?

Do you have any concerns about this?

Convince for the treatment given with reassurance in between…

don’t worry you will be alright / everything will be fine

It is the best option for you

I strongly recommend the surgery for you.

I am also hoping for the best results…

I guess anyone might have the same reaction but it is the best option for you

But we can’t say definitely that you will be cured

Red flags: It can spread to other parts of the body

Refer :

I would like to refer you to oncologist /surgeon/palliative team …….

Don’t worry, you will be in safe hands

Review: (if given in the task)

Is there anything else I can help you with today?

Please be in constant touch with us about the concerns you may come (provide support)

It is good idea to talk to someone about this, do you have any relative or friend who can provide you the
support..

I wish the best for you; you have got many options available. we hope that we can cure this.

Would you like me explain this to any of your family members?

Again I am hoping best for you, no matter what happens.

Goodbye, we will be in touch..!

Finish the task..