“effective communication is truly essential to good cancer care and deserves more research”

 

This is the message from a report in the US by their National Cancer Institute and the University of Rochester.

As one of the co-authors, Ronald M. Epstein, says

“You can have the best treatment in the world but if you don’t understand it, or have access to it, it does you no good.”

The article is titled “Patient-Centered Communication in Cancer Care: Promoting Healing and Reducing Suffering“.

However, this is not as simple as it may sound.  Options for treatment can be complex: their are five year survival rates for the different options and differing side effects.  This can lead to patients needing to make very complicated calculations about what this means for their lives – as well as the lives of their friends and loved ones.

A friend of mine was diagnosed with a melanoma at a very young age – in their thirties.  They had taken precautions against exposure to the sun since childhood – very rarely for an Australian they had never even been badly sunburned once in their life.  This person was presented with statistical information on their treatment option in terms of percentages.  Their very natural reaction was: but the odds have already gone against me –

so what do these statistics really mean? 

Communication, and assisting patients make decisions, is much more than just preventing ‘facts’.

The change in culture that the internet has brought has also changed the challenges for communication between doctor and patient.  Up until a couple of decades ago the doctor would be the source of information for the patient.  Now the patient may well be overwhelmed with information.  The doctor’s role is not to inform but to help sort through a mass of information that the patient may already have from the internet.  (In my experience this has never been done well by any doctor.)

Finally a correction.  Mr Epstein believes that doctors in other countries may be better at communicating with patients than they are in America.  He believes that Australian patients receive audio recordings of their visits.  I can assure him that if this ever happens in Australia, it is very far from usual.

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