The first line of defense: How primary care doctors can guide patients through a cancer diagnosis

My medical history includes 40 years of intergenerational cancer experiences and a BRCA1 gene mutation. Once, when I visited my doctor for recurring pain in my elbow, he conducted a breast exam. When I asked what my breasts had to do with my elbow, his response was priceless: “You will never come into this office for any issue without getting a breast exam because I will NOT be the doctor who missed the tumor.”

With an 80% lifetime probability of breast cancer, he had a point. He never found the tumor, and in a cruel irony, cancer took him before I was eventually diagnosed. His diligence, however, underscored a critical truth: Primary care doctors often play the first — and most pivotal — role in the fight against cancer.

The vast majority of cancer diagnoses will be identified by non-oncology physicians: primary care doctors, OB-GYNs, internists and others. With approximately 2,001,140 new cancer cases diagnosed in the United States each year — excluding basal cell and squamous cell skin cancers as well as in situ carcinomas (except for urinary bladder cancer) per the National Institutes of Health — these physicians inevitably, albeit infrequently, deliver life-shattering news.

Today, innovations in treatment and early detection are saving more lives, allowing many to live long, healthy lives after cancer. However, when a patient first hears the diagnosis, the uncertainty of their journey is overwhelming. For doctors, the challenge lies in guiding their patients with empathy, clarity and support while balancing the limits of their own knowledge of the state of the art in cancer treatment.

The role of primary care doctors

Non-oncology doctors are uniquely positioned to provide not only the initial diagnosis but also critical support during the early, most bewildering phase of a patient’s cancer journey. By serving as a trusted guide, they can help their patients make sense of a complex and emotionally charged situation.

Following are key recommendations for how primary care doctors can best support the newly diagnosed.

Top things a non-oncology doctor can do for the newly diagnosed

1. Communication is key

Time the conversation thoughtfully: If you are calling to deliver the diagnosis, ensure the patient is not driving and, preferably, not alone.

Encourage note-taking: Ask them to have a pen and paper ready. A cancer diagnosis is shocking, and patients often retain very little of what they hear initially. Writing down key points can help them process the information later.

Manage expectations: Reassure them that most cancers, even aggressive ones, don’t require immediate treatment. A one- to four-week timeline to complete tests and prepare for treatment is typical. Encourage swift action without panic.

2. Be a trusted guide

Explain what comes next: The patient will soon face a whirlwind of medical terms, appointments and decisions. Offer to help them understand the choices and translate technical language.

Connect them to experts: Recommend an oncologist who specializes in their cancer type and pathology, if possible, before referring to a surgeon. Oncologists can coordinate a comprehensive plan and involve surgeons if needed. Encourage second opinions, especially through a National Cancer Center specialist.

Caution against internet overload: Advise waiting until they meet with a specialist before diving into internet research. Explain that cancer treatments are highly specific to the stage, pathology and individual response. Recommend reputable sources like Cancer.org and the American Cancer Society for general guidance.

3. Provide practical and emotional support

Cancer nurse navigators: These professionals guide patients through the health care system, reducing stress and improving outcomes. If available, connect your patient with one immediately.

Psycho-oncology referrals: Encourage early mental health support through therapists trained in supporting cancer patients and their families.

Encourage family communication: Advise patients to clearly articulate what they do and don’t want from their community (e.g., no unsolicited health advice or family cancer stories).

4. Avoid common pitfalls

Don’t make guarantees: Avoid statements about treatment outcomes. Uncertainty is difficult, but making unfounded assurances can undermine trust.

Stay in your lane: Avoid suggesting treatment alternatives unless you are current on specific protocols for their cancer. The rapid pace of medical innovation means even well-meaning advice may conflict with the oncologist’s plan, creating confusion and doubt.

5. Practical guidance on scheduling and resources

Help with scheduling: Assist patients in booking their first oncology appointment before they leave your office. This small act can reduce fear and uncertainty.

Financial challenges: Cancer treatment often comes with significant financial burdens. Younger patients may need to reduce work hours or take short-term disability. While you’re not their financial planner, refer them to a social worker or nonprofit for guidance. Tools like my financial scenario tool can also help patients anticipate financial stressors.

A cancer information kit for your office

Providing an in-person information kit ensures patients leave your office with resources in hand. Include the following:

• A notepad and pen for note-taking
• A list of referrals for psycho-oncologists, social workers and cancer nurse navigators
• Contact information for local or national cancer support organizations

Long-term relationship building

Cancer is a life-changing event, but it doesn’t have to define your patient’s future. With many cancers now successfully treated, your relationship with the patient can endure well beyond their cancer journey.

Periodic check-ins during treatment — a quick call or note asking how they’re managing — can go a long way in building trust and catching potential complications early.

As a primary care physician, your guidance at the start of a patient’s cancer journey can provide the confidence, hope and resilience they need to navigate this difficult chapter in their life. By offering thoughtful support and connecting them with the right resources, you make a lasting impact on their journey to recovery.

Closing thoughts

Your commitment to your patients is the foundation of their strength in facing cancer. While delivering a cancer diagnosis is never easy, your empathy, expertise and guidance start their journey with hope, confidence and connection.

Joelle Kaufman is the author of “Crushing the Cancer Curveball: A Playbook for the Newly Diagnosed, Their Family And Friends.” Her life has been shaped by breast cancer since age 13, culminating in her own 2023 diagnosis — the fourth in her immediate family. As CEO and Founder of GTM Flow, she combines cancer-forged resilience with cutting-edge go-to-market leadership strategies.