A 80 yo man was unfortunately diagnosed with lung cancer. Extremely anxious to begin with, made worse by the fact that his grandson has recently died from metastatic cancer.
He wasn’t able to tolerate lying down flat, he told me. Even for his diagnostic CT, he had to lie on his side. He and his wife said he will panic if he were to lie down.
Told him I will offer him radiotherapy, but when I described the treatment to him, he quickly dismissed it, saying there is no way he will manage lying down fro radiotherapy. He was already in panic whilst I was talking to him about treatment. His face became all red, his respiratory rate went up.
It was really difficult, but eventually I managed to convince him to simply give it a try; if he cannot manage it, we will not force him. I told him I have helped many anxious people through it. I prescribed him some lorazepam to take before coming for treatment.
Saw him last week for consent. Still very suspicious, anxious and doubtful. Certain that he will not manage. Eventually managed to get him planned without any major issue.
A week later, a very happy man. Couldn’t stop thanking me. Wife said he is a totally new person, so I’ve got the patient a totally happy wife as well.
Sounded like he has major anxiety disorder; probably should stay on some anxiolytic for the rest of his life.
