One in three patients reports a knowledge gap about the side effects of cancer treatment

When meeting with oncologists to discuss treatment plans, newly diagnosed cancer patients must process a significant amount of new information.

“They come with their families, they come with their notebooks, they ask meaningful questions.” Narek Shaverdian, MD, A radiation oncologist at the Memorial Sloan Kettering Cancer Center told Healio: “But the first diagnosis and first steps in planning a treatment include not only side effects, but also a lot of discussion about what comes with the treatment and how it works. That’s a lot. “

Shaverdian was the lead author of a study showing that one in three adults receiving cancer treatment may feel that they do not have enough information about treatment-related information. Harmful effects They experience.

Sponsored by the American Society of Radiation Oncology for this study Journal of Oncology Practice, Shaverdian and colleagues conducted a national survey of more than 400 adults in the United States who received cancer treatment.

For each major cancer treatment, about one-third of patients reported that they had treatment-related side effects that they wanted to know more about (radiotherapy, 37%, chemotherapy, 36%, surgery, 34%).

Those who experienced severe treatment-related side effects were much more likely to indicate that they felt uninformed than those who had only mild side effects (38% vs. 4%).

Regardless of treatment approach or side effects, most patients surveyed did not regret treatment, Shaverdian said.

Nalek Shabadian

“Nine out of ten of our patients said they felt they had made the right decision about their treatment,” he told Healio. “It was a really good takeaway.”

Shaverdian, Healio, the meaning of this study, Potential toxicity Other aspects of treatment may be more clearly communicated to the patient before treatment.

Question: Why do you think patients do not have complete information about their treatment in advance?

Answer: Given the complexity of cancer treatment these days, it’s not surprising that some messages are disrupted. These patients usually do not receive another treatment. They undergo surgery, chemotherapy, radiation therapy, and immunotherapy. So it’s a complicated matter. Sometimes these discussions go on for a long time. You can talk to the patient about some of these side effects, but they are probably not ready to discuss that part of the treatment. Maybe they just want to know: It can be quite overwhelming.

Q: Q: In your survey Most patients reported consulting with a primary care physician regarding treatment. Is PCP a good source of this information?

A: That’s a difficult question. Most patients consult multiple sources regarding treatment. Half of our patients had access to cancer-related websites or cancer support groups, at least at the time of this study. However, most patients have a long-lasting relationship with PCP. Initial diagnosis was often facilitated by findings at the primary care clinic. However, it is unclear if patients will have all the toxicity information available through their GP. As a provider of radiation oncology, I find it very comfortable to talk about the complexity of radiation toxicity. When giving radiation therapy with immunotherapy, chemotherapy, or surgery, you can talk about some of the overlapping areas. The toxicity of these treatments is also a bit more complicated. You need a trained professional to get the big picture of things.

Q: Do you think the oncologist spends enough time discussing treatment plans with the patient?

A: All patients are different. “Doctor, I trust you. I just want to move forward. Tell me the next steps.” But other patients tell you they are afraid to start treatment because of side effects. maybe. For these patients, side effects need to be elaborated before scheduling treatment. The fact that most patients felt that they had made the right treatment decision and that their toxic experience was in line with their expectations suggests that these detailed discussions are tailored to the patient. doing. Still, one-third of patients felt they wanted a little more information. That was the case for people who had surgery, chemotherapy, or radiation therapy.

Q: What kind of information did the patient want more?

A: Patients who said there were some gaps in their understanding of what to expect tended to be those who experienced more serious side effects. Therefore, they may not have predicted how serious these effects would be. That makes sense. Because when talking to patients about side effects, they say, “You can feel tired, but for most patients, fatigue is not that serious.” If you are one of the patients who has that severe fatigue or other side effects, it is anxious because you are not part of the majority who have had different experiences.

When counseling a patient, we spend a lot of time talking about toxicity and do it many times. I try to articulate the expectations that patients should have, not only during treatment but also in the future. It needs to be balanced as these patients may need treatment to stay alive and enjoy life.

Q: Q: Are there any other changes that I think should be made in the light of your findings?

A: It is always good to evaluate how you communicate with your patients, especially with all the resources there. Such research is necessary to gain a patient’s perspective on how the patient is doing. They are those who are treated and experience reality. Therefore, such investigations need to be repeated from time to time to ensure that we are doing a good job.

Patients have access to superior resources through organizations such as the American Society for Radiation Oncology and ASCO. For radiation, there are RT Answers. This is a great source of information about what you can expect from treatment. We need to make sure that the patient is aware of these resources and that the provider is aware of where they are counseling the patient. This is always available to our attention and rating.

For more information:

Nalek Shabadian, MD, It can be reached at 650 Commack Road, Commack, NY11725.