ASCO News Article:Most Oncologists Aren't on Prognosis

[Guest guest]

ASCO: Most Oncologists Aren't on Prognosis with Terminal Patients

By Peggy Peck , MedPage Today Staff Writer

Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of

Pennsylvania School of Medicine.

 

MedPage Today Action Points

This survey suggests that oncologists often back away from giving a detailed

prognosis to patients. Review communication with patients to determine

whether

you are communicating clearly and in a fully useful way.

This study was published as an abstract and presented at a conference either

as an oral or poster presentation. These data and conclusions should be

considered to be preliminary as they have not yet been reviewed and

published in a

peer-reviewed publication.

 

Review

ORLANDO, May 15-Only 5% of oncologists always give their patients estimates

of survival time, researchers reported here today. But 75% of oncologists

say

they would want such estimates themselves if they had terminal cancer.

Asked about this " do as we say not as we do " approach, K.

Daugherty, M.D., of the University of Chicago, who presented the survey

results at

the American Society of Clinical Oncology meeting here today, said it may

reflect physicians' perception of patients' wishes.

He noted, for example, that 49% of oncologists surveyed said " they either

ask

patients if they want to know prognostic information or wait for the patient

to ask for the information. "

And the oncologists uniformly rated themselves as good communicators, with

90% saying that they and their patients are " usually satisfied with their

communications. " But Dr. Daughtery said that he had no patient satisfaction

data to

support the oncologists' self-views, which he said probably " overestimate "

the

oncologists communication skills.

Dr. Daugherty sent mail surveys to a national sample of 1,200 oncologists

asking specific questions about how the oncologists communicate with

patients

" where death is expected within six to 12 months. " Sixty-four percent of

those

surveyed responded.

Bruce E. , M.D., director of the Lowe Center for Thoracic Oncology at

the Dana-Farber Cancer Institute in Boston and associate professor of

medicine

at Harvard Medical School, said he thinks the survey data are accurate " if

you look at the way they put it -- 'estimates of survival.' What I hear is

that

most oncologists, myself included, don't like to use specific numbers. What

is

more common is for an oncologist to give ranges because survival is a

bell-shaped curve: some patients fall in the middle but others are at either

end of

the curve. "

Among the other findings of the survey:

Ninety seven percent said that communication teaching should be part of

cancer-care training, but only 27% said they had such training themselves

and 80%

said they either didn't receive communication training or that the training

was

inadequate.

While most oncologists rated themselves as good communicators, women

oncologists were less likely to give themselves high marks as communicators.

Older oncologists with more time in practice were more likely to report that

their communication practices had evolved, but Dr. Daugherty said that there

was no clear pattern. People who didn't give estimates decided to give

survival

estimates, while those who started out giving estimates, decided that was

too

much information.

The study was funded by the McCann Foundation, the National Cancer Institute

and the Soros Foundation's Project on Death in America.

Disclaimer

The information presented in this activity is that of the authors and does

not necessarily represent the views of the University of Pennsylvania School

of

Medicine, MedPage Today, and the commercial supporter. Specific medicines

discussed in this activity may not yet be approved by the FDA for the use as

indicated by the writer or reviewer. Before prescribing any medication, we

advise

you to review the complete prescribing information, including indications,

contraindications, warnings, precautions, and adverse effects. Specific

patient

care decisions are the responsibility of the healthcare professional caring

for

the patient. Please review our Terms of Use.