Patients With Advanced Cancer Often Misunderstand Their Prognosis

MedicalResearch.com Interview with:

Robert Gramling, MD, DSc Division of Palliative Medicine, University of Vermont, Burlington Department of Family Medicine Burlington Vermont School of Nursing and Department of Public Health Sciences Center for Communication and Disparities Research, Department of Family Medicine, and Division of Palliative Care, Center for Community Health, University of Rochester School of Medicine and Dentistry, Rochester, New York

Dr. Robert Gramling

Robert Gramling, MD, DSc
Division of Palliative Medicine, University of Vermont,
Burlington Department of Family Medicine
Burlington Vermont
School of Nursing and Department of Public Health Sciences
Center for Communication and Disparities Research, Department of Family Medicine, and Division of Palliative Care,
Center for Community Health, University of Rochester School of Medicine and Dentistry,
Rochester, New York

MedicalResearch.com: What should readers take away from your report?

Response: Patients with advanced cancer often misunderstand their doctor’s expectations about the length of life they have remaining and this misunderstanding is relevant to their preferences for sharing in treatment decisions at end of life.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Patient-centered prognosis communication in advanced illness is a dynamic and relational process that takes place in context of available treatments and sources of suffering.

In many ways, “conversations in context” are similar to ecological systems. For example, depending on the ecosystem, one type of bird thrives and another does not. This way of scientific thinking can help us get beyond the false assumption that there is one right way to communicate prognosis. Rather, there are likely thousands of right ways as long as each approach is understood within the context of the patient’s decision-making “environment”. Future research should welcome methods that embrace this complexity and “ecology of prognosis conversations” to help us engineer our training, systems and healthcare environments to foster meaningful communication.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Gramling R, Fiscella K, Xing G, et al. Determinants of Patient-Oncologist Prognostic Discordance in Advanced Cancer. JAMA Oncol. Published online July 14, 2016. doi:10.1001/jamaoncol.2016.1861.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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