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Home > Newsroom > News Releases 10 ways to make better decisions about cancer careU-M researchers outline how to improve communication about risk-added 09/21/2011Ann Arbor - Talking with doctors about cancer and cancer treatments can feel like learning a new language, and people facing cancer diagnoses often need help to understand their treatment options, and the risks and benefits of each choice.
"People are making life and death decisions that may affect their survival and they need to know what they're getting themselves into. Cancer treatments and tests can be serious. Patients need to know what kind of side effects they might experience as a result of the treatment they undergo," says Angela Fagerlin, Ph.D., associate professor of internal medicine at the University of Michigan Medical School and a University of Michigan Comprehensive Cancer Center researcher. Fagerlin and colleagues have published a commentary in the Journal of the National Cancer Institute that outlines 10 things health care professionals can do to improve the way they communicate information about treatment risks to patients. Here, they explain how patients can tap into these same best practices to become fluent in the language of cancer care and better understand their options.
1. Insist on plain language.
If you don't understand something your doctor says, ask him or her to explain it better. "Doctors don't know when patients don't understand them. They want patients to stop them and ask questions," says Fagerlin, who is also a research scientist at the VA Ann Arbor Healthcare Center. 2. Focus on the absolute risk. Sometimes, the effect of cancer treatments is described using language like "this drug will cut your risk in half." But, such relative risk statements don't tell you anything about how likely this is. Research has shown that using relative risk makes both patients and doctors more likely to favor a treatment, because they believe it to be more beneficial than it actually may be. If, instead, your doctor told you that "the drug will lower your risk of cancer from 4% to 2%," now you know that most people won't get cancer regardless. And it will give you the exact benefit you would get from taking the drug. Fagerlin suggests asking doctors for this absolute risk information for a truer picture. 3. Visualize your risk. 4. Consider risk as a frequency rather than as percentages. 5. Focus on the additional risk. 6. The order of information matters. 7. Write it down. You may be presented with a lot of information. At the end of the discussion, ask your doctor if a written summary of the risks and benefits is available. Or ask your doctor to help you summarize all the information in writing. 8. Don't get hung up on averages. 9. Less may be more. 10. Consider your risk over time. If you're told the five-year risk of your cancer returning after a certain treatment, ask what the 10-year or 20-year risk is. In some cases, this data might not be available, but always be aware of the timeframe involved. Additional author: Peter A. Ubel, M.D., Duke University Funding: National Institutes of Health
Written by: Nicole Fawcett
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