Sharlene Gill, MD, MPH, MBA, FRCPC, is a professor in the Department of Medicine in the Division of Medical Oncology at The University of British Columbia in Canada. 

Dr Gill on a Survey of Patient Experiences and Involvement in Decision-Making in CRC

“Patient voice is increasingly important in the conversations that we have about treatment choice. We often, not inappropriately, focus heavily on the data and the statistics. We are increasingly learning that the patient voice is important in terms of implementation and acceptance of treatment.”

Sharlene Gill, BScPharm, MD, MPH, MBA, FRCPC, a professor in the Department of Medicine in the Division of Medical Oncology at The University of British Columbia, discussed the implications of the results of a survey of patients with metastatic colorectal cancer (CRC) from Canada and Europe, which examined their treatment experiences and involvement in decision making.

Gill was the coauthor of a poster that was presented during the 

2025 ESMO Gastrointestinal Cancers Congress

, findings from which showed that a significant proportion of adult patients with metastatic CRC who responded to a 60-question online survey (n = 814) wanted to have a better understanding of their disease and treatment options. Specifically, respondents from Canada (n = 183), the United Kingdom (n = 154), Germany (n = 143), Spain (n = 142), and Portugal (n = 143) indicated that they wanted a better understanding of their diagnosis at respective rates of 37%, 56%, 48%, 46%, and 47%. Moreover, patients reported wanting a better understanding of treatment options, including access to clinical trials, at rates of 54%, 47%, 38%,37%, and 50%, respectively. Patients wanted to have a better understanding of disease progression at respective rates of 43%, 53%, 45%, 42%, and 43%.

Gill noted that these findings underscore the importance of the patient’s voice in conversations regarding treatment choice. Often, the tendency is to focus heavily on the data; however, investigators are learning that the voice of the patient is equally important for facilitating better treatment implementation and acceptance, she added. Additionally, patient organizations should be leveraged globally to proactively connect patients with the appropriate support systems, she concluded.

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Sharlene Gill, BScPharm, MD, MPH, MBA, FRCPC, discusses patient experiences and involvement in decision-making in CRC.

Dr Gill on the Rationale for Surveying Patients With mCRC About Treatment Decision-Making

“What we want to better understand is: How do patients interpret those data, and what kind of factors influence their treatment decision-making? Knowledge of that not only acknowledges the patient journey and the patient experience, but also helps us to better understand how to communicate information to a patient when we’re in that time of trying to make a decision about next options for treatment and what factors the patients [are] considering, in addition to what we as providers think are important."

Sharlene Gill, BScPharm, MD, MPH, MBA, FRCPC, a professor of the Faculty of Medicine in the Department of Medicine at The University of British Columbia Division of Medical Oncology, discussed the rationale for conducting a study of patients’ treatment experiences and involvement in treatment decision-making regarding their metastatic colorectal cancer (mCRC) care. 

An important aspect of cancer drug development involves understanding how patients interpret clinical trial data and what factors influence their treatment-related decision making, Gill began. Gaining insight into these perspectives validates the patient experience and acknowledges the complexity of their treatment journey, as well as informs how oncologists can most effectively communicate information during discussions regarding subsequent lines of therapy, she explained. In practice, mCRC treatment decisions are not guided solely by clinical parameters considered important by oncologists; patients incorporate a range of personal values and concerns into their decision-making process, she said. This underscores the importance of shared decision-making, where care teams—beyond the oncologist alone—actively engage with patients to identify their preferences and priorities, she emphasized. A central component of this approach is explicitly asking patients what matters most to them in the context of their care, she added.

For example, some patients may express significant worry about becoming a burden on their family, Gill shared. Proactively addressing this concern by identifying available resources and supports can help mitigate that anxiety and prevent patients from feeling entirely dependent on family members, she noted. By directly acknowledging these concerns within the consultation, oncologists can reduce uncertainty and avoid situations where patients leave the clinical encounter with unresolved questions or unspoken fears, she stated.

Sharlene Gill, BScPharm, MD, MPH, MBA, FRCPC, discusses the rationale for evaluating patient experiences and involvement in CRC treatment decision-making.

Sharlene Gill, MD, MPH, MBA, FRCPC, highlights the importance of considering patients’ concerns ahead of treatment decision-making for advanced CRC.

Dr Gill on Considering Patients’ Concerns Before Treatment Selection in Advanced CRC

“In terms of factors that drive [patients’] treatment choices, the top 3 things were related to adverse effects, [and how they will] affect them in terms of tolerability, quality of life, and the concern about being a burden on their family. The [last] one struck me in terms of the conversations I have with my patients—often we don’t address that.”

Sharlene Gill, MD, MPH, MBA, FRCPC, a professor in the Department of Medicine in the Division of Medical Oncology at The University of British Columbia, highlighted the importance of considering patients’ top concerns during the treatment decision-making process for advanced or metastatic colorectal cancer (CRC).

A 60-question online survey was distributed to patients with advanced or metastatic colorectal cancer (n = 800) in Canada, the United Kingdom, Portugal, Germany, and Spain. The purpose of the survey was to ask patients about their experience with cancer, including how information is often communicated to them, how they’d like information to be communicated to them, and the key factors that influence their treatment decision-making. Based on the results of the survey, patients reported that although they rely on their oncology teams, they also heavily rely on friends and family and support networks, such as social media and peer support groups, Gill began. However, most patients also stated that they were not familiar with patient organization groups available to them in their respective countries, she reported. Therefore, she emphasized that this was a gap that could be closed by connecting patients with patient organizations with the support patients are seeking.

Furthermore, most respondents of the survey were younger, at an average age of 50 years, which reflected a patient population who were more likely to actively participate in a shared treatment decision-making process, Gill continued. Aspects that informed patients’ treatment choices included the tolerability of treatment, quality of life with adverse effects, and the possibility of being a burden on family members were the top 3, she said. A surprising response was that patients believed they would be a burden on their family, which is not often discussed or addressed, according to Gill. Additionally, results from the survey demonstrated that patients desire a holistic approach to address their psychosocial and financial needs, which are realistic opportunities for change when caring for patients with advanced or metastatic CRC, she concluded.

Sharlene Gill, MD, MPH, MBA, FRCPC

Articles

Dr Gill on a Survey of Patient Experiences and Involvement in Decision-Making in CRC

Dr Gill on the Rationale for Surveying Patients With mCRC About Treatment Decision-Making

Dr Gill on Considering Patients’ Concerns Before Treatment Selection in Advanced CRC