A breast cancer community of patients, advocates, physicians, and nurses from 26 countries propose actions to improve doctor-patient communication
Likely every cancer patient can remember what it was like to learn of their diagnosis. They can perhaps also remember how in the following days, they thought about their mortality, what their treatments would be like and how they would care for their families, or maybe continue working, in the weeks and months ahead.
“Doctors need to think about the way they deliver the bad news,” says Dr. Luzia Travado, who leads psycho-oncology at Champalimaud Clinical Center in Lisbon, Portugal. “Maybe the patient is alone, and doesn’t have family or friends around to support them. Regardless, he or she will be startled by the news, so empathy is very important.”
Dr. Travado participated in the third metastatic breast cancer summit (MBC Summit) sponsored by Pfizer Oncology. The most recent MBC Summit was held in Berlin and drew 70 individuals from 26 countries, including patients, patient advocates, physicians, nurses, and psycho-oncologists. Over the last three years, the group has worked together to identify areas where metastatic breast cancer (mBC) patients need support, worked together to create solutions, and then rolled out the resulting initiatives in their own countries.
Most recently, Travado and the group members considered how to improve communication between doctors and patients and together developed consensus recommendations which center on four steps: Prepare, Ask, Listen, and Motivate, or shortened to PALiMo. Now the group is working in their own countries to bring the PALiMo recommendations to the broader medical community. The goal is to publish the guidelines and also to incorporate them into existing clinical treatment guidelines, which often lack critical details on how to communicate.
Dr. Travado hails the guidelines as both innovative and necessary. As a clinical health psychologist and psychotherapist, she has spent much of her career helping cancer patients navigate the complex feelings surrounding their diagnoses and treatments. She specializes in clinical health psychology and has pioneered numerous programs for patients with chronic diseases, particularly women with breast cancer and metastatic breast cancer.
“It was innovative of Pfizer to bring all of us together,” she says. “The guidelines are written in everyday language that reflects the strong collaboration within the group and patient preferences, which is unique and very important.”
The participating health care professionals, she also notes, learned how critical it is to motivate patients as they start their treatments, and how preparation before delivering bad news is paramount.
“The doctors shouldn’t be reading the patient’s history when they first meet,” says Dr. Travado. “But rather that time should be used for face-to-face talking with the patient about any concerns, to listen and to explain. Patients need their doctors to keep them hopeful.
The guidelines also address communication during treatments.
But work remains to spread the work, she adds. “I am very optimistic; I have seen how much this group has already accomplished in so many countries and their motivation to improve the situation for patients living with mBC.”
For a copy of the PALiMo recommendations, please click here: