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Senior Citizen Health & Medicine
Communication in World of Cancer Victims is Key to
Survival
New report says need is greater as information grows
 Sept. 19, 2007 - For the 10 million Americans who
are living with cancer or have survived it, one factor may be most
indispensable for keeping their spirits intact: communication. In
recognition of this, the National Cancer Institute plans to issue a
special report by November 1, co-authored by a University of Rochester
physician, stating that effective communication is truly essential to
good cancer care and deserves more research.
Without the ability to understand what is
happening, how can patients make life-altering medical decisions, cope
with and find meaning in their journey, or navigate a complex health
care system"
“The public is really struggling with these
issues,” said co-author Ronald M. Epstein, M.D., professor of Family
Medicine, Psychiatry and Oncology at the University of Rochester, and
Director of the Rochester Center to Improve Communication in Health
Care.
“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.”
Traditional relationships with doctors dictated
that patients followed orders and trusted the professionals to solve all
problems. Modern society and modern medicine turned this upside down:
Access to the Internet and treatment advances have changed what used to
be a deficit of information into information overload. As a result, both
patients and physicians must have the skills to communicate so they can
filter, deliberate together and manage the uncertainty that comes with
cancer.
“In short, communicating clinical evidence is more
than just ‘stating the facts,’” according to the NCI report.
“Communication is necessary during all phases of the cancer continuum
from prevention through survival and end-of-life care.”
Epstein and co-author Richard L. Street, Jr.,
Ph.D., professor and head of the Department of Communications at Texas
A&M University, were commissioned by the NCI Division of Cancer Control
and Population Sciences. Their work, titled “Patient-Centered
Communication in Cancer Care: Promoting Healing and Reducing Suffering,”
written in collaboration with NCI scientific staff, identifies
priorities for research in cancer communication that could lead to
better patient outcomes.
For example, the report addresses how doctors
typically present survival data to patients. How should a doctor relay
that Treatment A might result in a 70 percent chance of surviving for
five years, with a 10 percent chance of harsh side effects, while
Treatment B might result in a 60 percent chance of survival with minimal
side effects" What is the best way to frame information to reduce
patient anxiety and yet not be overly hopeful"
“All of this can be studied empirically,” Epstein
said. “Ultimately, we need to structure our health care system so that
it fosters excellent communication and improves access to information,
particularly among those patients who are most disadvantaged.”
Epstein noted that other countries are ahead of the
United States in some ways. Patients in the United Kingdom can write
notes in their own medical records; Australians receive audio recordings
of their doctor visits. The NCI report underscores a previous report by
the Institute of Medicine (IOM) that identifies “patient-centeredness”
as a cornerstone of improved health.
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