Discussing prognosis: Balancing hope and realism

Toby C. Campbell, Elise C. Carey, Vicki A. Jackson, Biren Saraiya, Holly B. Yang, Anthony L. Back, Robert M. Arnold

Research output: Contribution to journalReview article

48 Scopus citations

Abstract

"How much time do I have?" A patient's question about his/her life expectancy is among the most difficult of conversation topics. Oncologists, often with very little training in communication, routinely handle these requests for sensitive information. Oncologists are aware of the emotional weight surrounding a prognosis discussion: answering a prognosis question poorly can damage both a patient's sense of hope and the relationship with his/her physician. Conversely, when handled well, the discussion can affirm the relationship, build trust, and leave the patient feeling hopeful. Our review presents clinicians with a practical approach to handling prognosis discussions by dealing with 4 critical issues. First, we review what information should be conveyed about a patient's prognosis. Next, we provide tools to help the oncologist deal with a patient's emotional reaction. Then, we provide a framework for the discussion that helps preserve a patient's hope despite a poor prognosis. Finally, we address the impact on the physician and provide some suggestions for dealing with our own emotional reactions.

Original languageEnglish (US)
Pages (from-to)461-466
Number of pages6
JournalCancer Journal
Volume16
Issue number5
DOIs
StatePublished - Sep 1 2010

Keywords

  • Cancer prognosis
  • hope
  • realism

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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