The Test of "How are You?"

Why should the answer to 'How are you doing?' be the ultimate test of how patients are doing only after treatments fail?"

After posting Measuring Status without Scans, I realized a paradigm shift seems to take place after treatments stop working. Suddenly, what patients say about how they feel becomes the defining guide for knowing how they are doing and what needs to be done. The "test results" are patients' answers to questions such as, "How well are you able to eat? Sleep? Get to the bathroom? How much pain are you experiencing? What meaningful or joyful things are you doing during your awake time?" 

During treatment, many patients struggle with the uncertainty about their condition and their future. If asked, "How are you?," many patients are tempted to answer, "I'll find out when I get my scan results!"

For Healthy Survivors, diagnostic tests tell them only how the cancer is doing--and not how they are doing. They elicit reactions that play into how patients feel; they don't define how patients are. 

From the time of diagnosis, the ultimate "test results" that matter are patients' answers to "How are you doing today?" That's the best way to know if they are getting what they need to (1) get good care and (2) live as fully as possible, the two criteria of Healthy Survivorship.

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