Monday, 2 March 2015

Teaching the patients to pose a timely question

Peter Ubel is a doctor by profession and a researcher at Duke University in North Carolina, primarily in human condition and its relation to health, happiness and generally the way in which society works. He is the author of "Critical Decisions".

I chose this tweet because it leads to a blog of the Cancer Today, journal of the American Association for Cancer Research which states that posing the right question can help patients suffering from metastatic cancer to understand the risks and benefits of the treatments and to more appropriately formulate their personal goals. Palliative chemotherapy may improve the quality of lives for metastatic patients, but once the cancer spreads, the treatment decisions are increasingly complex, the conversations between doctors and patients are increasingly emotional and in such a delicate environment, the statistics may even mislead.

In a study published in NEJM in October 2012, 1.200 stage IV lung or colorectal cancer patients with were interviewed. All of them received palliative chemotherapy with the intention of improving symptoms and prolong their life for weeks or months. However, 69% of lung cancer patients and 81% colorectal cancer patients were unaware that the treatment had no curative intentions. This data only confirms that, at certain stages of the disease, the words and numbers that appear at the doctor’s office only feed a world of misunderstandings and gaps more or less intended during the communication between doctor and patient.

Dr. Ubel argues that, in the final stage of cancer clinical trial, doctors have a professional and moral obligation to help sufferers to ask the right questions, so that they can get more precise, more understandable and more truthful answers to questions as: "what is the probability, doctor, that my tumour will be reduced by half after this treatment?" instead of speaking of generic statistics or using vague words.

Jordi Varela

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