Communication between cancer patients, doctors needs to improve, study says

Oncologists are not always responsive to patient concerns and patients often misunderstand diagnoses, but training can improve the situation.
By Stephen Feller  |  Sept. 9, 2016 at 3:54 PM
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ROCHESTER, Minn., Sept. 9 (UPI) -- Gaps between how oncologists speak to patients about cancer and what patients understand from those conversations can create unrealistic expectations and potentially less-than-ideal selection of treatments, but researchers think they've found a way to improve the situation.

With specialized training for doctors and counseling to help patients ask better questions, researchers at the University of Rochester found communication was significantly improved between oncologists and their patients.

Many patients want to be more involved in decisions about their treatment but don't have a good enough understanding of what may or may not happen, including their prospects for recovery after cancer treatment had concluded.

"We need to embed communication interventions into the fabric of everyday clinical care," Dr. Ronald Epstein, a professor of family medicine at the University of Rochester, said in a press release. "This does not take a lot of time, but in our audio-recordings there was precious little dialogue that reaffirmed the human experience and the needs of patients. The next step is to make good communication the rule, not the exception, so that cancer patients' voices can be heard."

For the study, published in the journal JAMA Oncology, the researchers recruited 38 oncologists and 265 adults with advanced nonhematologic cancer between 2012 and 2014.

After randomizing the participants, doctors in the study group received individualized communication training and patients were given question prompt lists and coaching to better ask about their specific disease. The interventions, researchers say, were focused on engaging patients during consultations, responding to emotions, information patients about prognosis and treatment choices and offering more balance to information patients received. Those in the control groups were not given any type of training.

Doctors and patients who received training reported more effective communication, though there was not a noticeable difference in survival and the researchers note this may be linked to all participants having stage 3 or 4 cancer. Additionally, the researchers report doctors that did not receive training requested it at the conclusion of the study.

"We need to try harder to communicate well so that it's harder to miscommunicate," Epstein said. "Simply having the conversation is not enough -- the quality of the conversation will influence a mutual understanding between patients and their oncologists."

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