A writer and a host in OncoDaily, psychologist Adrian Pogacian, shares his perspective on communicating the oncological diagnosis with patients. This article focuses on adult patients and oncologists.

Communicating the oncological diagnosis: Part 1 – Adults

“Delivering bad news is a difficult part of working with the oncological patient. And, statistically, half of the doctors suffer emotional stress after conveyed the bad news.

It is known that healing begins immediately after the patient receives the oncological prognosis. Furthermore, it is recognized that bad news is any information that will negatively change patient’s view of their future, therefore the truth about their own medical condition should be communicated immediately and entirely in all cases or scenarios. Consequently, communicating cancer diagnosis becomes an issue of great importance, for both: the patient and the doctor.

It is of major importance to approach the situation of delivering bad news from the interpersonal perspective, which means an interaction between two people (in majority of cases patient and doctor), each with their own aspirations and concerns about the meeting.

The feeling of taking patient’s hope away along with a sense of helplessness are believed to be the biggest impediment for medical staff in communicating the oncological diagnosis to the patient.

The need to face their own emotions and to manage stress in order to overcome patient’s tears and fears, as well as the feeling of professional failure, had been considered the biggest discomfort and requires self-control management to overcome these challenges.

Therefore, it should be a balance between emotional and cognitive aspect of a difficult conversation with the patient, between speaking clearly, providing the patient with all of the information and being supportive and hopeful.

Although, physicians or psychologists are considered to be healers, they can’t avoid giving bad news because of a fear of causing pain or a fear of saying I don’t know. Patients need to be heard and must be understood.

I personally believe we should let them talk about their concerns as much time as they need; hence we have to avoid jargon and deliver bad news in clear terms and plain language, otherwise the majority of patients misunderstand what is important regarding their diagnosis.

The patient should be physically comfortable, in a quiet room without distractions or interruptions and should be encouraged to speak, which is an important part in the process of healing the shock of cancer diagnosis. Active listening skills, such as repetition, reiteration, and reflection, can console the patient because he feels that you are concern about his case.

But, the most important thing is: do not interrupt the patient unless absolutely necessary, obviously short pauses can occur when emotions are intense.

To conclude, there are different protocols and approaches though, in reality, no one is fully prepared in deliver bad news and not all of us have good communication skills. Nevertheless, what really matters is the empathy with the patient and the interpersonal connection that occur during its treatment.”

by Adrian Pogacian.
Clinical Psychologist with focus in Psycho-Oncology