Communication between patients and health care providers

Cancer survivors face many challenges resulting from the side effects of treatment, the effects of the cancer itself, and the many emotions that accompany their illness. Cancer survivors often fear recurrence, suffering, or death and feel sad or angry when bad things happen. Discussing emotional issues with patients is challenging. One reason that emotional conversations are so uncomfortable is that formal communication skills training is underemphasized during medical education and training, which primarily focuses on biomedical issues. Discussing difficult questions or concerns takes health care providers out of the familiar biomedical realm and thrusts them into the less comfortable psychosocial realm. However, these challenging conversations can be turned into opportunities to establish trust and rapport with a few key communication strategies. These strategies include exploring patientsTM concerns; listening actively; seizing empathic opportunities when emotions arise; engaging in natural, free-flowing conversations; and allowing space (silence) in the conversation. These key strategies can be applied to discussions of a variety of clinical scenarios, including recurrence or fear of recurrence, prognosis, and other difficult conversations.