Oncologists could improve prognosis communication: Study

Study findings show that improvements need to be made in doctor-patient conversations regarding end-of-life care.
By Amy Wallace   |   Jan. 24, 2017 at 2:52 PM

Jan. 24 (UPI) -- Researchers from the University of Colorado Anschutz Medical Campus found that accurate prognosis of incurable cancer is vital to end-of-life decision making.

The study looked at 64 doctor-patient conversations regarding cancer prognosis at four major academic medical centers and found that both patients and doctors tend to avoid end-of-life discussions regarding terminal cancer diagnosis.

"It was surprising -- at all four of these medical centers, the conversations that oncologists had with their patients tended to follow the same pattern," Dr. Sarguni Singh, oncology hospitalist at the University of Colorado Cancer Center and author of the study, said in a press release. "They would discuss symptoms, then the oncologist would reveal scan results often followed by an immediate transition to talking about the next steps for treatment. What's often missing is a discussion of what the scan results mean."

The research was part of a large, multi-site cancer clinical trial and an average of 50 percent of the conversations regarding a negative diagnosis centered around treatment options. Researchers found that just 10 percent of the conversations were about scan results, and there were only four instances where oncologists discussed prognosis with patients.

"The oncologist doesn't want to give a negative view and the patient doesn't want to hear it," Singh, who worked with Dr. Toby C. Campbell on the study, said. "They collude to avoid this elephant in the room. Most importantly, these prognosis conversations aren't happening. If it does, it happens very quickly. And patients aren't processing the news."

Singh suggests oncologists take the time to ask patients if they want to talk about what the test results mean and what the next steps should be going forward.

The study was published in the Journal of Oncology Practice.

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