When it comes to communicating with malignant mesothelioma patients and their families, a longitudinal approach where patients are followed throughout their cancer journey may be most effective.
That is the suggestion of a lung cancer communication study newly published in the European Journal of Cancer Care.
Researchers at the University of Heidelberg in Germany and the University of Utah Population Health Sciences Department conducted interviews with nine patients with metastatic lung cancer and nine of their relatives, as well as with a panel of 15 healthcare providers involved in their care.
“Patients and relatives described a situation of shock and coping deficits with moments of insufficient communication and lack of continuity of care,” writes study author Matthias Villalobos, MD, a thoracic oncologist with University Hospital Heidelberg.
Pleural Mesothelioma Patients May Face Similar Challenges
Patients with pleural mesothelioma, a rare lung-related cancer, are likely to face challenges similar to those with advanced lung cancer when trying to understand and come to terms with their diagnosis, prognosis, and mesothelioma treatment options.
Like metastatic lung cancer, the survival outlook for malignant mesothelioma is often grim. Shock, grief, and confusion may make any existing communication issues between patients and providers even worse.
But the German study suggests that the situation can be improved. The study found that the providers caring for the lung cancer patients agreed that there were communication breakdowns and they were open to training in better ways to manage them.
The providers cited communication challenges within the cancer treatment team and, according to researchers, “welcomed the implementation of a longitudinal communication approach.”
Longitudinal Communication for Pleural Mesothelioma Families
With a longitudinal approach, mesothelioma patients would have a point of contact not only at the beginning of their treatment journey, but throughout the process. The goal is to help avoid confusion and allay fears by providing ready access to information and support.
New cancer communication guidelines issued by the American Society of Clinical Oncology also recommend that healthcare providers “ask first, then tell”, inviting people with malignant mesothelioma and other types of cancer to ask questions and voice concerns at the beginning, rather than at the end, of each visit.
The ASCO guidelines also recommend that cancer doctors ask questions such as “Does that make sense to you?” or invite patients to explain what the doctor has just said.
For their part, patients and families are advised to write down and bring to each appointment questions they have about their pleural mesothelioma diagnosis or about mesothelioma treatment.
Villalobos, M, et al, “A longitudinal communication approach in advanced lung cancer: A qualitative study of patients’, relatives’ and staff’s perspectives”, November 23, 2017, European Journal of Cancer Care, Epub ahead of print
Gilligan, T, et al, “Patient-Clinician Communication”, September 11, 2017, ASCO.org