Multidisciplinary Management of HER2+ Breast Cancer - Episode 6
Recommendations for deciding what information is most important to discuss with patients during initial treatment planning for HER2-positive metastatic breast cancer.
Sara A. Hurvitz, MD: Kamran, I want to turn to you. Patients struggle with a lot of information, clinicians struggle with the change in data and information available to help guide treatment decisions. More and more, we’re learning how to integrate shared decision-making with patients and it’s quite a fine balance. You don’t want to overwhelm patients with too much data, but you also want to be sharing in the decision with patients regarding what treatment you’re going to ultimately pursue. How do you manage that in your own practice? How do you sort out how much data to give them? Do you share clinical trial data with them? Do you show them guidelines? Are there patient-facing materials like pamphlets, etc., that you’re utilizing? How do you integrate this in your own patient discussions?
Kamran Ahmed, MD: That’s a good question. It’s very patient-dependent. Every patient is different. For some patients they want to see the specifics in terms of clinical trial data. In those instances, I’ll certainly pull out clinical trials and rates and give specific numbers. In other instances, patients want to know what my opinion is and what I would recommend for a member of my own family. In those instances, I’ll specifically state what I would recommend. One of the easiest things to do is to get NCCN [National Comprehensive Cancer Network] guidelines. Moffitt Cancer Center [Tampa, Florida] is an NCCN institution and we follow those guidelines closely and if patients want to know what exactly kind of the standard of care [is] right now, that’s something that I also like to use. Above all, I try to tell patients that this is a team approach and although I’m here to provide guidance, ultimately treatment decisions are in their hands.
Sara A. Hurvitz, MD: You’ve made some great points and talking to the patient about how they want to receive information, what they’re comfortable with is certainly important. Some patients want the nitty-gritty detail and have already done their own research and will surprise you by asking you very specific questions about clinical trials and others want your gut instinct based on your experience.
Transcript edited for clarity.