SAN FRANCISCOThere is no shortage of educational programs on terminal care, advance directives, and breaking bad news to cancer patients. However, an equally challenging task is often overlooked in these training sessions: what to say when treatment fails to cure or control the disease.
At this difficult transition from therapy to palliation, physicians need to strike a delicate balance between "providing honest disclosure and maintaining realistic hope," said Geoffrey H. Gordon, MD, an associate director at the Bayer Institute for Health Care Communication. That way, "when the treatment fails the patient, you don’t feel like a failure yourself," he said.Dr. Gordon described Bayer Institute’s workshop designed to address these issues in a special session held before the 37th American Society of Clinical Oncology meeting.
Effectively communicating at the transition may be easier than many oncologists think. One study showed that patients who hear just 40 seconds of empathy will be less anxious and will see their physician as more pleasant, helpful, and caring.
"There is a tremendous amount of empathy among clinicians, but you would never know it by watching their behavior," Dr. Gordon said. "It does not get expressed. However, it does not cost you time and does not turn the consultation into a psychotherapy session."
The 4-hour "Care Not Cure" workshop consists of brief lectures interspersed with case-based exercises, a video/discussion section, and a conclusion/evaluation. Tapes of patient-physician dialogues are used to trigger discussions among participants and generate ideas.
Participants receive an annotated bibliography of published articles that clarify important aspects of communication when patients transition from cancer treatment to symptom control.