事件记录
面试官: What does a physician want their lung cancer patient to know after a positive diagnosis? 大发娱乐将在接下来的节目中找到答案.
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面试官: Dr. 华莱士·阿克利（华莱士阿克尔）就职于亨茨曼癌症研究所. 他是肺癌专家，我想和他简单谈谈. 当你有一个确诊为肺癌的病人, 你通常会告诉他们什么? 因为当时, it's probably a little overwhelming so this might give that patient opportunity to hear that information again?
Dr. 华莱士: So the first thing we talk about with a patient is typically explaining what's happened is in the past and every patient has to know what the cancer is and where it has spread. 所以这个测试他们可能理解，也可能不理解, but the what part is a biopsy and they've probably already had that before they come to see me. We look at it under the microscope and explain or look at these cancer cells and see that these were once normal cells that are behaving very differently. And they can see that under the microscope that the cell that's supposed to be contained to the lung has somehow figured out a way to grow right through basement membranes. 所以活组织检查表明这个细胞行为不正常，这是癌症.
第二部分是它在哪里传播. And the patient has typically gone through a CT scan or a PET scan and draw out a picture that says these are the places where your cancer is present. Knowing where the cancer has gone and that it is a cancer helps the patient explain in their own mind or understand what their symptoms are and why they're feeling the way they're feeling. 它可能与癌症有关，也可能与癌症无关. 但当大发娱乐开始治疗这些症状时, 它能让病人明白说什么, "I can treat this as an arthritis or I can treat this with my as-needed medications they have at home as a cancer."
面试官: 你还想跟病人解释什么?
Dr. 华莱士: So the next thing is to understand what made the cancer the cancer and so the old world, 大发娱乐看了活检后说, “这就是癌细胞的样子." The new world is taking it one step further and we are now doing gene studies. Genes of the cancer that tell the cancer what to do and we can find which of these genes is responsible in very many cases for making the cancer the cancer. 癌症就是大发娱乐的正常细胞, 除了大发娱乐正常功能的一部分被劫持和损坏. 如果我能理解是哪一步导致的, 好吧, then we can talk about drugs to block that pathway or at least try to blunt it if I can't correct the pathway.
交替, I can pick out a pathway and potentially prescribe them a targeted therapy or a specific therapy that makes the cancer the cancer. Surprisingly, these therapies can be much more 好吧 tolerated and more active. So everything is a balance of how 好吧 does it work, how many side effects does it cause. And these targeted therapies could easily be a pill that one takes at home and can have the side effects of almost taking an antibiotic, something so different than the chemotherapy that we've been giving for 20 or 30 years.
面试官: 在整个过程中，家庭成员是多么重要啊?
Dr. 华莱士: 家庭是如此重要. 有时家庭承受的痛苦比病人承受的还要大. The family tends to have to keep stiff upper lip and say they'll be strong for the patient so matter what. 是的, 这对病人来说很难, but the family suffers with this too so I think it's very important to have family members there. They hear the same background information that the patient hears and their role is to listen and try to understand it as 好吧 as the patient because the patient, 非常常见的, 只是被这些信息淹没了吗.
即使我把这些写下来，我也把打印出来的信息发给大家, 人们不能总是记住它. 他们有时完全被“癌症”这个词困住了.“有时他们会感到惊讶, 但很常见的是，他们晚上回家后会说, “我不记得他们说了什么,“他们看着大发娱乐分发的这些手写笔记，然后说, “哎呀. This note says this," and they can then remember with that trigger what it was that we talked about.
大发娱乐通常谈论的是标准治疗. “大发娱乐会这样做，看看效果如何”，但癌症的一切都很简单. 大发娱乐测量一些东西，大发娱乐给出治疗，大发娱乐再测量一次. 如果癌细胞变小了，大发娱乐做的是对的. 如果癌细胞没有变小，大发娱乐需要一个新计划. And so we will list the number of potential treatments we have and we usually end off with where do we think the world is going because the first thing the family does and the patient does when they get home is they get on the internet and they look around.
面试官: 确定.
Dr. 华莱士: 所以重要的是让他们明白，“这就是我所在的地方. 这就是我要做的. This is how my nurses and social workers and physician are going to support me as I get through this. This is my team that will educate my family members so they will help support me,“大发娱乐将在适当的时候进行这些治疗. 大发娱乐会平衡好处和副作用. 如果可能的话, we'll try to get them involved with therapies that might be available in two to three years.
面试官: 所以听起来这不仅仅是一种身体疾病的诊断, there is also treatment for the mental and the spiritual and there is a lot of supporting roles involved other than just you telling somebody, “对不起. 你得了肺癌. 大发娱乐去做这个治疗吧."
Dr. 华莱士: 太对了. 大发娱乐作为一个团队来对待. 没有人是孤立的. 大发娱乐有很多专长. 大发娱乐有外科医生, radiation therapists and pathologists and so on in the physician group that is interested in the cancer. 但大发娱乐关心的远不止这些. It's important to have social workers in the cancer 好吧ness center and the cancer learning center and all of these other things to give the patient the strength to be able to get through this. It's a terrible diagnosis, but there is hope and there are many new therapies. 在过去的几年里，有很多药物获得了批准. 在我的疾病中, 对于肺癌, there have been two new therapies approved that work by completely different mechanisms. 非常非常有前途.
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