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    Cancer Docs Often Miss Patient Fears

    Doctors Respond With Empathy Only One-Fourth of Time, Study Shows
    WebMD Health News
    Reviewed by Louise Chang, MD

    Dec. 18, 2007 -- Cancer patients who expect their oncologist to lend an empathetic ear are often disappointed, new research suggests.

    Researchers found that the emotional concerns of patients with advanced cancer often went unrecognized or unaddressed by the doctors treating them.

    The researchers recorded close to 400 conversations between oncologists and patients and then counted how often the patients sought empathy from the doctors and how often the doctors responded empathetically to patient concerns.

    Showing support or asking patients to elaborate on their concerns, legitimizing the expressed emotion and praising patients for their strength were all considered empathetic responses.

    When the patients expressed concerns and negative emotions, the oncologists responded empathetically 22% of the time.

    Researcher Kathryn Pollak, PhD, of Duke Comprehensive Cancer Center, says the findings illustrate the need for teaching oncologists better communication skills.

    "We know that oncologists care deeply for their patients," she tells WebMD. "They wouldn't be in the field if they weren't caring people. But they often don't verbalize their feelings to their patients."

    Difficult Questions, Difficult Answers

    Pollak recounted one exchange from the recorded conversations that went like this: When the patient told her oncologist that she had been really depressed lately, the oncologist responded, "So are you still smoking?"

    Pollak says patients often ask difficult questions in indirect ways, and their doctors may or may not pick up on this.

    "Patients may ask if their tumors are getting bigger, but what they are really saying is they are scared their cancer is getting worse," she says.

    The researchers found that younger oncologists were more likely to respond empathetically than older ones, possibly because training in communication is being stressed more in medical schools today.

    Carma Bylund, PhD, who runs a communications skills training course for oncologists at New York's Memorial Sloan-Kettering Cancer Center, tells WebMD the younger doctors in her program have often had courses in patient communication.

    "There has been a definite shift," she says. "Younger residents and interns tell me they did a lot of this in medical school, while older fellows or attending physicians say no one ever talked about it."

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