Will I be diagnosed with cancer? Uncertainty is part of healthcare. Embrace it | Opinion

You want answers. Most doctors want to give them to you. But the reality is healthcare is full of uncertainty.

Medical tests don’t always provide information. Misdiagnoses happen. Treatments may not work or have unintended side effects.

Yet rather than facing these uncertainties, doctors and patients often avoid them. But uncertainty does not mean medicine has failed.

As a researcher at the University of South Florida who studies healthcare communication and as a patient with an inherited mutation in the BRCA2 gene — which greatly increases my lifetime risks for breast cancer, ovarian cancer and pancreatic cancer — I’ve seen how uncertainty plays out in personal and life-altering decisions.

Will I be diagnosed with cancer? Should I undergo a preventive bilateral mastectomy to reduce my breast cancer risk? Will my children face the same cancer risks I do? How will my family members react to this genetic information?

The podcast “The Nocturnists“ recently featured a series called “Uncertainty in Medicine.” Using storytelling from patients and doctors, they explored how people experience and navigate unknowns. The hosts noted that when there’s ambiguity, it’s tempting to keep ordering tests, offering more opinions or giving overconfident predictions.

Yet the series concluded that we should expect uncertainty, accept uncertainty and step into uncertainty. In short, instead of trying to eliminate uncertainty, we need to learn to manage it — and fast.

According to a recent report, the United Nations Development Program designated uncertainty as a worldwide problem equaling a crisis level. This challenge has never been more urgent.

Today, we are living in a time of heightened and unexpected uncertainty across many areas of life.

In this context, managing uncertainty means doctors and patients need to build trust, show empathy and engage in honest, ongoing conversations that acknowledge what is known and unknown, as well as work together to create a plan of action.

Additionally, since patients live the majority of their lives outside of the medical encounter, doctors also need to teach patients self-management skills such as journaling or meditation. These skills help at 2 a.m. when the uncertainty is suffocating or emotional distress is triggered from a post on TikTok.

Managing uncertainty also requires a mindset shift. For doctors, it means letting go of the idea that authority requires having all the answers.

This is especially important in fields like genetics and oncology where uncertainty is often the norm. It means being willing to say, “I don’t know” It means partnering with the patient to explore the best next step and adjusting expectations.

For patients, it means expecting uncertainty, anticipating its effects and responding. I learned about my inherited BRCA2 mutation over a decade ago, and I am better at managing uncertainty because I’ve been living with it.

For example, I used to have “scanxiety” during MRIs every six months. Now I know what to expect — increased worry, heavier breathing — and so I capture those thoughts and react more quickly. I also talk about my uncertainty with these appointments, rallying my doctors, family and friends who send encouragement and prayers. I have grown in dealing with uncertainty.

To be sure, managing uncertainty is difficult. It takes time and practice. But when it is acknowledged and communicated well we can embrace it.

In a healthcare system where patients face chronic health issues and doctors are stretched thin, we need to acknowledge uncertainty as part of medical interactions. We need to train doctors to talk about it and equip patients to ask about it and manage it outside medical encounters.

We can’t eliminate uncertainty in healthcare, research or society. But we can learn to talk about it, manage it and ultimately accept it. This is the perspective we need, now more than ever.

Marleah Dean Kruzel is an associate professor at the University of South Florida, a collaborator member in the Health Outcomes & Behavior Program at the Moffitt Cancer Center and a member of the Tampa General Cancer Institute. Her research focuses on uncertainty, medical decision-making and communication of genetic risk information.