Good communication between patients with cancer, family caregivers, and the health care team helps improve patients' well-being and quality of life. Communicating about concerns and decision making is important during all phases of treatment and supportive care for cancer.
The goals of good communication in cancer care are to:
Patients, their families, and their health care team face many issues when cancer is diagnosed. Cancer is a life-threatening illness, even though advances in treatments have increased the chances of a cure or remission. A patient who is diagnosed with cancer may feel fear and anxiety about treatments that are often difficult, expensive, and complicated. Decisions about the patient's care can be very hard to make. Good communication can help patients, families, and doctors make these decisions together and improve the patient's well-being and quality of life.
Studies show that when patients and doctors communicate well during cancer care, there are many positive results. Patients are usually:
Patients and their families should let the health care team know how much information they want about the cancer and its treatment. Some patients and families want a lot of detailed information. Others want less detail. Also, the need for information may change as the patient moves through diagnosis and treatment. Some patients with advanced disease want less information about their condition.
There may be differences in how involved patients and families want to be in making decisions about cancer care. Some patients and families may want to be very involved and make their own decisions about cancer care. Others may want to leave decisions to the doctor.Communication is important at different points during cancer care.
Communication is important throughout cancer care, but especially when important decisions are to be made. These important decision times include:
Studies have shown that cancer patients who have end-of-life discussions with their doctors choose to have fewer procedures, such as resuscitation or the use of a ventilator. They are also less likely to be in intensive care, and the cost of their health care is lower during their final week of life. Reports from their caregivers show that these patients live as long as patients who choose to have more procedures and that they have a better quality of life in their last days.
This summary is about communication needs in adults and children with cancer. Section titles show when the information is about children.
Families can help patients make better decisions about their cancer care. Patients and their family members can join together as partners to communicate with the doctor and health care team. When possible, patients should decide how much help they want from family members when making decisions. Communication between family caregivers and the health care team should continue throughout cancer care. It should include information about the goals of treatment, plans for the patient's care, and what to expect over time.Communication with the doctor helps caregivers as well as patients.
Communication that includes the patient and family is called family-centered communication. Family-centered communication with the doctor helps the family understand its role in caregiving. Family caregivers who get specific and practical direction from the health care team are more confident about giving care. When caregivers receive this help, they can give the patient better care.Language and culture can affect communication.
Communication can be more difficult if the doctor does not speak the same language as the patient and family, or if there are cultural differences. Every patient with cancer has the right to get clear information about the diagnosis and treatment so he or she can take full part in making decisions. Most medical centers have trained interpreters or have other ways to help with language differences.
If cultural beliefs will affect decisions about treatment and care, the health care team should be told about these beliefs. For example, a common Western belief is that an informed patient should make the final decision about cancer care.There may be problems with communication.
There are many things that can block communication between the patient and doctor. This can happen if:
Family caregivers can sometimes help when communication problems come up.
Studies show that children with cancer want to know about their illness and how it will be treated. The amount of information a child wants depends in part on his or her age. Most children worry about how their illness and treatment will affect their daily lives and the people around them. Studies also show that children have less doubt and fear when they are given information about their illness, even if it is bad news.There are many ways for parents to communicate with their child.
When a child is seriously ill, parents may find that communication is better when they:
It is helpful for patients and caregivers to plan ahead for doctor visits. The following may help you get the most out of these visits:
Patients and family caregivers should talk before the appointment to help get ready for possible bad news or information that is different than expected.Patients and caregivers can make a checklist of specific questions about treatment.
When talking with the doctor, ask specific questions about any concerns you have. If an answer is not clear to you, ask the doctor to explain it in a way that you can understand. Include the following questions about the patient's treatment:
Check NCI’s list of cancer clinical trials for U.S. supportive and palliative care trials about communication intervention that are now accepting participants. The list of trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
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A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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National Cancer Institute: PDQ® Communication in Cancer Care. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://www.cancer.gov/about-cancer/coping/adjusting-to-cancer/communication-pdq. Accessed <MM/DD/YYYY>.
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