Communication between clinicians and patients is a multidimensional concept and involves the content of dialogue, the affective component (i.e., what happens emotionally to the physician and patient during the encounter), and nonverbal behaviors. In oncology, communication skills are a key to achieving the important goals of the clinical encounter. These goals include establishing trust and rapport, gathering information from the patient and the patient's family, giving bad news and other information about the illness, addressing patient emotions, and eliciting concerns.[2,3,4] Effective and supportive communication can assist the patient and his or her family in navigating a successful transition to palliative care. Moreover, the need for truly informed consent and the patient's right to health care information and compassionate care create ethical, legal, and humanistic mandates for competency in oncology communication.
In this summary, unless otherwise stated, evidence and practice issues as they relate to adults are discussed. The evidence and application to practice related to children may differ significantly from information related to adults. When specific information about the care of children is available, it is summarized under its own heading.
The Gonzalez regimen, developed by Dr. Nicholas Gonzalez, involves taking pancreatic enzymes thought to have anticancer activity. The regimen also includes prescribed diets, nutritional supplements, and coffee enemas (see Question 1).
The Gonzalez regimen is based on the theory that pancreatic enzymes help the body get rid of toxins (harmful substances) that lead to cancer (see Question 3).
A few studies have examined the effect of pancreatic enzymes in animals with implanted cancers, but...
Check NCI's list of cancer clinical trials for U.S. supportive and palliative care trials about communication intervention that are now accepting participants. The list of trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
Levy MH: Doctor-patient communication: the lifeline to comprehensive cancer care. In: Perry MC, ed.: American Society of Clinical Oncology Educational Book: Thirty-Fourth Annual Meeting, Spring 1998. Alexandria, Va: American Society of Clinical Oncology, 1998, pp 195-202.
Parle M, Jones B, Maguire P: Maladaptive coping and affective disorders among cancer patients. Psychol Med 26 (4): 735-44, 1996.
Roberts CS, Cox CE, Reintgen DS, et al.: Influence of physician communication on newly diagnosed breast patients' psychologic adjustment and decision-making. Cancer 74 (1 Suppl): 336-41, 1994.
Buckman R: Communications and emotions. BMJ 325 (7366): 672, 2002.
Detmar SB, Muller MJ, Schornagel JH, et al.: Role of health-related quality of life in palliative chemotherapy treatment decisions. J Clin Oncol 20 (4): 1056-62, 2002.
Baile WF: Communication competency in oncology: legal, ethical and humanistic imperatives. [Abstract] Psychooncology 15 (Suppl 2): A-13, S6, 2006.
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September 04, 2014
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