Dr Meisel on Communication Barriers Between Patients and Oncologists in Breast Cancer

Jane L. Meisel, MD, associate professor, Department of Hematology and Medical Oncology, associate professor, Department of Gynecology and Obstetrics, Emory University School of Medicine, discusses the rationale for launching an investigation of adverse effect (AE)–related communication challenges that currently exist between patients with breast cancer and their oncologists.

The premise behind this initiative stemmed from the recognition that AEs associated with cancer treatments are often underreported in clinical trials, as well as in patient advocacy conversations and research, altering patients’ perceptions of these AEs, Meisel begins. AEs can significantly diminish patient quality of life (QOL) and influence treatment decisions, she adds. However, there exists a gap in understanding the extent to which AEs influence treatment decisions and how comfortable patients feel discussing these issues with their health care providers, Meisel explains. To address this gap, investigators explored this issue among a diverse group of patients with metastatic breast cancer by creating a comprehensive survey, she notes.

This survey probed various facets of patient-oncologist communication barriers using multiple channels, such as patient advocacy networks, as well as social media platforms like Facebook and Twitter, to ensure a broad representation of patient responses, she continues. The survey encompassed basic demographic inquiries regarding patient age, menopausal status, urban or rural residence, income level, and educational background, Meisel notes. Additionally, the survey delved into treatment-related queries, including the number of treatments patients had received and prior use of endocrine therapy or chemotherapy vs targeted therapy in patients with ER-positive disease, she elucidates.

Moreover, the survey extensively examined aspects of QOL and toxicity, including patients' concerns regarding specific AEs, the impact of these AEs on patients’ daily lives, and whether patients had ever withheld or minimized information when reporting AEs to their health care providers, Meisel expands. Furthermore, the survey explored the concept of decisional regret, investigating whether patients had ever regretted taking medication because of the AEs they subsequently experienced. These inquiries collectively captured a comprehensive understanding of the impact of AEs on patients' treatment experiences and decision-making processes, she concludes.