D = doctor, P = patient
D:	Hi. Have a seat. My name’s Dr Stephens. I know you’ve previously been seeing my colleague, Dr Iglesias.
P:	Er…Nice to meet you. Yes, that’s right. Ah, … Dr Iglesias. She had a scan done …. for … gallstones.
D:	I see. Right. So, could you just tell me what has happened since then? I just want to get up to speed so that I’ve got a clear picture of what has happened up to now.
P:	Well, I had the scan and they rang me a few days later to say that I needed to come for a second scan, … to get to see everything in more detail, I suppose.
D:	OK.
P:	… and that was … Tuesday I think. Yes, Tuesday this week. I went and had another scan. And then … then you phoned me, and here I am.
D:	OK. Good. So between the first scan and the second scan, was it your doctor who phoned you, or was it the imaging department who did the scan?
P:	It was the department, actually … a Dr Biswas, I think, who phoned to say that they’d made another appointment for the follow-up scan.
D:	And did they give you any idea why they needed to do an extra scan?
P:	Ah, no, they didn’t, actually. I asked, of course, but they didn’t say what the reason was.
D:	Yeah. I see. And do you have any thoughts about why they called you for a second scan?
P:	I suppose it’s because they found gallstones and needed a bit more information.
D:	OK. So, now can you tell me about the symptoms you’ve been having. I do have your scan results here and there is something we need to discuss, but first I want to make sure I know what’s been happening and what your symptoms are, before we go into the details.
P:	Well, I guess it started a few months ago, ah, … with a fairly constant pain, like a stomach ache that wouldn’t go away, so I made an appointment with ah … Dr Iglesias, who decided to have the first scan done. And that was just a week or so ago.
D:	Ah ha.
P:	Then a few days later I got the phone call about the second one.
D:	OK. So do you still have pain at the moment?
P:	Yeah. It’s pretty much there all the time really.
D:	OK. Well, as I said, your scan results have come through today and I’m afraid there is something that is potentially worrying.
P:	Oh. Really?
D:	Yes.
P:	I didn’t expect that.
D:	No.
P:	So, what’s worrying about it?
D:	Well, in the first scan there was something suspicious, at the top of the pancreas gland.
P:	Suspicious?
D:	Yes. The pancreas is here at the top of the abdomen, and it’s quite close to the gall bladder, so, in the first scan they saw this and wanted more information on it, so they called you back for a second scan, which is a CT scan, a very detailed one, to see exactly what the situation is. And this second scan shows that there is definitely something on your pancreas gland.
P:	Really.
D:	Yes. … And what we need to worry about is whether or not this could be some kind of cancer.
P:	Oh. …. That is a surprise. I wasn’t expecting that.
D:	No. … I’m very sorry to have to tell you like this, but I felt that it was important to tell you as soon as we received the results, so that you know exactly what the situation is. … Now, I know, I’ve just given you a big, unexpected piece of news, …
P:	Oh yeah.
D:	… so do you have any questions at this stage that I can answer for you?
P:	Ah, … I don’t know. Ah, the pancreas, … so if it is a cancer, can they operate, or, …. how would they treat that?
D:	It depends. The pancreas is a gland at the top of the abdomen, as I said, and it controls some of the fluids and hormones that your body requires. Because it's at the back of the abdomen we don’t really notice it at all unless there is a problem of some kind, which is the pain that you’ve been experiencing. But in answer to your question, I don’t know what could be done about it. What we need to do now is to ask the specialist. So, … the specialist can look at your scan today and see you as well and then see if they agree, that they think it could be cancer, and then what the plan of action could be.
P:	OK.
D:	Now, I understand that I’ve just given you a lot of information, some worrying information and ...
P:	You bet! I wasn’t expecting this at all.
D:	… I mean, is there someone who could come in with you tomorrow to chat more after you’ve had a bit more time?
P:	Yeah, I guess so. But, … no, actually, I’ll come by myself. That’s fine.
D:	Are you sure?
P:	Yeah, that’s fine.
D:	But it is important to say at this stage that we don’t know definitely if it is cancer . We have to imagine that it is something like a cancer until we prove that it’s not. So we have to do everything very quickly to find out as soon as possible and get some answers for you.
P:	Right.
D:	So, let’s make another appointment for tomorrow, when we can continue our chat. You’ll probably have more questions by then.
P:	Yes, sure.
D:	OK. I have printed out some information about this type of cancer, … if this is what it is. So, I wonder if you might want to have a bit of a read of this before you come back tomorrow. … what this does is explain what the pancreas does and then …