Communicating Risks of Adjuvant Chemotherapy for Breast Cancer: Getting Beyond the Laundry List

Eden R. Brauer, Elisa F. Long, Joy Melnikow, Peter M. Ravdin, Patricia A. Ganz

Research output: Contribution to journalArticle

Abstract

PURPOSE:: According to the Institute of Medicine, high-quality cancer care should include effective communication between clinicians and patients about the risks and benefits, expected response, and impact on quality of life of a recommended therapy. In the delivery of oncology care, the barriers to and facilitators of communication about potential long-term and late effects, post-treatment expectations, and transition to survivorship care have not been fully defined. PATIENTS AND METHODS:: We collected qualitative data through semistructured interviews with medical oncologists and focus groups with breast cancer survivors and applied the Theoretical Domains Framework to systematically analyze and identify the factors that may influence oncologists' communication with patients with breast cancer about the long-term and late effects of adjuvant therapy. RESULTS:: Eight key informant interviews with medical oncologists and two focus groups with breast cancer survivors provided data. Both oncologists and patients perceived information on long-term effects as valuable in terms of improved clinical communication but had concerns about the feasibility of inclusion before treatment. They described the current approaches to communication of therapy risks as a brief laundry list that emphasized acute adverse effects and minimized more long-term issues. We describe the barriers to communication about potential long-term effects from the perspectives of both groups. CONCLUSION:: This study provides insight into oncologists' communication with patients with breast cancer regarding the potential long-term and late effects of adjuvant chemotherapy and about setting realistic expectations for life after treatment. Opportunities to improve oncologists' communication about the potential toxicities of therapy, particularly regarding long-term and late effects, should be examined further.

Original languageEnglish (US)
Pages (from-to)e98-e109
JournalJournal of oncology practice
Volume15
Issue number2
DOIs
StatePublished - Feb 1 2019

Fingerprint

Adjuvant Chemotherapy
Communication
Breast Neoplasms
Focus Groups
Therapeutics
Survivors
Interviews
Communication Barriers
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Quality of Health Care
Statistical Factor Analysis
Oncologists
Survival Rate
Quality of Life
Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)
  • Health Policy

Cite this

Communicating Risks of Adjuvant Chemotherapy for Breast Cancer : Getting Beyond the Laundry List. / Brauer, Eden R.; Long, Elisa F.; Melnikow, Joy; Ravdin, Peter M.; Ganz, Patricia A.

In: Journal of oncology practice, Vol. 15, No. 2, 01.02.2019, p. e98-e109.

Research output: Contribution to journalArticle

Brauer, Eden R. ; Long, Elisa F. ; Melnikow, Joy ; Ravdin, Peter M. ; Ganz, Patricia A. / Communicating Risks of Adjuvant Chemotherapy for Breast Cancer : Getting Beyond the Laundry List. In: Journal of oncology practice. 2019 ; Vol. 15, No. 2. pp. e98-e109.
@article{ea23f0a5451d4a898effff30aac9e76b,
title = "Communicating Risks of Adjuvant Chemotherapy for Breast Cancer: Getting Beyond the Laundry List",
abstract = "PURPOSE:: According to the Institute of Medicine, high-quality cancer care should include effective communication between clinicians and patients about the risks and benefits, expected response, and impact on quality of life of a recommended therapy. In the delivery of oncology care, the barriers to and facilitators of communication about potential long-term and late effects, post-treatment expectations, and transition to survivorship care have not been fully defined. PATIENTS AND METHODS:: We collected qualitative data through semistructured interviews with medical oncologists and focus groups with breast cancer survivors and applied the Theoretical Domains Framework to systematically analyze and identify the factors that may influence oncologists' communication with patients with breast cancer about the long-term and late effects of adjuvant therapy. RESULTS:: Eight key informant interviews with medical oncologists and two focus groups with breast cancer survivors provided data. Both oncologists and patients perceived information on long-term effects as valuable in terms of improved clinical communication but had concerns about the feasibility of inclusion before treatment. They described the current approaches to communication of therapy risks as a brief laundry list that emphasized acute adverse effects and minimized more long-term issues. We describe the barriers to communication about potential long-term effects from the perspectives of both groups. CONCLUSION:: This study provides insight into oncologists' communication with patients with breast cancer regarding the potential long-term and late effects of adjuvant chemotherapy and about setting realistic expectations for life after treatment. Opportunities to improve oncologists' communication about the potential toxicities of therapy, particularly regarding long-term and late effects, should be examined further.",
author = "Brauer, {Eden R.} and Long, {Elisa F.} and Joy Melnikow and Ravdin, {Peter M.} and Ganz, {Patricia A.}",
year = "2019",
month = "2",
day = "1",
doi = "10.1200/JOP.18.00162",
language = "English (US)",
volume = "15",
pages = "e98--e109",
journal = "Journal of Oncology Practice",
issn = "1554-7477",
publisher = "American Society of Clinical Oncology",
number = "2",

}

TY - JOUR

T1 - Communicating Risks of Adjuvant Chemotherapy for Breast Cancer

T2 - Getting Beyond the Laundry List

AU - Brauer, Eden R.

AU - Long, Elisa F.

AU - Melnikow, Joy

AU - Ravdin, Peter M.

AU - Ganz, Patricia A.

PY - 2019/2/1

Y1 - 2019/2/1

N2 - PURPOSE:: According to the Institute of Medicine, high-quality cancer care should include effective communication between clinicians and patients about the risks and benefits, expected response, and impact on quality of life of a recommended therapy. In the delivery of oncology care, the barriers to and facilitators of communication about potential long-term and late effects, post-treatment expectations, and transition to survivorship care have not been fully defined. PATIENTS AND METHODS:: We collected qualitative data through semistructured interviews with medical oncologists and focus groups with breast cancer survivors and applied the Theoretical Domains Framework to systematically analyze and identify the factors that may influence oncologists' communication with patients with breast cancer about the long-term and late effects of adjuvant therapy. RESULTS:: Eight key informant interviews with medical oncologists and two focus groups with breast cancer survivors provided data. Both oncologists and patients perceived information on long-term effects as valuable in terms of improved clinical communication but had concerns about the feasibility of inclusion before treatment. They described the current approaches to communication of therapy risks as a brief laundry list that emphasized acute adverse effects and minimized more long-term issues. We describe the barriers to communication about potential long-term effects from the perspectives of both groups. CONCLUSION:: This study provides insight into oncologists' communication with patients with breast cancer regarding the potential long-term and late effects of adjuvant chemotherapy and about setting realistic expectations for life after treatment. Opportunities to improve oncologists' communication about the potential toxicities of therapy, particularly regarding long-term and late effects, should be examined further.

AB - PURPOSE:: According to the Institute of Medicine, high-quality cancer care should include effective communication between clinicians and patients about the risks and benefits, expected response, and impact on quality of life of a recommended therapy. In the delivery of oncology care, the barriers to and facilitators of communication about potential long-term and late effects, post-treatment expectations, and transition to survivorship care have not been fully defined. PATIENTS AND METHODS:: We collected qualitative data through semistructured interviews with medical oncologists and focus groups with breast cancer survivors and applied the Theoretical Domains Framework to systematically analyze and identify the factors that may influence oncologists' communication with patients with breast cancer about the long-term and late effects of adjuvant therapy. RESULTS:: Eight key informant interviews with medical oncologists and two focus groups with breast cancer survivors provided data. Both oncologists and patients perceived information on long-term effects as valuable in terms of improved clinical communication but had concerns about the feasibility of inclusion before treatment. They described the current approaches to communication of therapy risks as a brief laundry list that emphasized acute adverse effects and minimized more long-term issues. We describe the barriers to communication about potential long-term effects from the perspectives of both groups. CONCLUSION:: This study provides insight into oncologists' communication with patients with breast cancer regarding the potential long-term and late effects of adjuvant chemotherapy and about setting realistic expectations for life after treatment. Opportunities to improve oncologists' communication about the potential toxicities of therapy, particularly regarding long-term and late effects, should be examined further.

UR - http://www.scopus.com/inward/record.url?scp=85061615607&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061615607&partnerID=8YFLogxK

U2 - 10.1200/JOP.18.00162

DO - 10.1200/JOP.18.00162

M3 - Article

C2 - 30550372

AN - SCOPUS:85061615607

VL - 15

SP - e98-e109

JO - Journal of Oncology Practice

JF - Journal of Oncology Practice

SN - 1554-7477

IS - 2

ER -