UPMC Hillman Cancer Center

December 2009

Last month at the annual meeting for the American Society of Radiation Oncology, Dr. Ajay Bhatnagar's study "What Patients Want From Their Radiation Oncologists" received significant attention from the media, including coverage by CNN, WebMD and the Associated Press. Dr. Bhatnagar's research explores concepts as intricate as how forthright patients want their physicians to be regarding their prognosis and as specific as whether or not patients care if their physicians wear white coats.

These explorations may seem out of context in the world of cancer research, but the area of physician/patient communication is incredibly complex and important. Continuing research shows time and time again that the relationship a patient has with his or her physician impacts the treatment decision he or she makes, and understanding the different qualities that impact the relationship is essential to ensure properly informed patients.

Last month, the U.S. Preventive Task Force recommended a change in mammography screening guidelines, pushing back the age a woman first receives a mammogram from 40 to 50 and receiving a mammogram every other year instead of every year, as previously recommended. On the heals of this announcement, the American College of Obstetricians and Gynecologists recommended changing the age a woman is first screened for cervical cancer from 18 to 21, and once she turns 30, only undergoing screening every 2-3 years. While the mammography guidelines made the biggest splash in the media, both sets of recommendations received considerable attention.

Patients wading through the various reactions and recommendations from different groups may find themselves confused about what recommendations are best for them, and it is here where physician/patient communication comes into play. The most important decision any patient can make in light of these new recommendations is to talk with his or her physician. The decision to undergo any medical test should be made in consultation with a primary care provider, regardless of age and taking into consideration patients' medical histories.

Cancer research and treatment is constantly evolving – it is by no means a static process. It would be nice, of course, if research followed a straight line, with point A leading directly to point B, but rarely is that the case. Instead researchers and physicians must remain flexible and open to what scientific, peer-reviewed research shows us, taking time to process the information and understand what it means for our patients.

At UPCI and UPMC CancerCenter, we will continue working to understand how physician/patient communication impacts health care decision-making, and we will strive to ensure our patients are informed and comfortable with the choices they make. When a patient is faced with new information or recommendations, the best thing he or she can do is talk to his or her physician. Like cancer research, physician/patient communication is a dynamic process, and one that succeeds when both parties participate to the best of their ability.