ASCO President on Patient-Doctor Relationships

You or your loved one has been diagnosed with cancer. As you start treatment, you’re looking to your care team to guide you through a physically and emotionally demanding health condition.

But for the best care possible, your relationship with your care team should be an active partnership. Your doctors will strive to give you clear, honest information about what’s going on within your body. In turn, you need to learn about your treatment options, know what to expect, and be open about your needs and your treatment experience. This way, your treatment will be what’s right for you.

In fact, according to Eric Winer, MD, a good patient-doctor partnership is the cornerstone of clinical care and research. Winer is director of the Yale Cancer Center and physician-in-chief at Smilow Cancer Hospital. He’s also president of the American Society of Clinical Oncology (ASCO).

Much of his commitment to patient care stems from his personal experience as a patient both in childhood and as an adult. It’s why he chose “partnering with patients” as the presidential theme for the 2023 ASCO Conference.

“It was a very deliberately selected theme. I do many things and have done many things in my career. I’ve educated, I’ve done research, I’ve taken care of patients. But everything that I do fundamentally has been based in patient care and has grown out of my interest in making patient care as good as it can possibly be for everyone,” Winer said.

Your cancer team isn’t just made up of your doctor. There are several other health care providers. This includes nurses, social workers, patient advocates, and other medical specialists. 

With so many people on board, open communication is the best way to make sure everyone is on the same page. This will help you juggle treatment options seamlessly – from chemotherapy appointments, doctor’s office visits, and insurance questions, to follow-up care. 

“I guess the way I like to think of this is that the medical team is an expert in the medical treatments. The patient and sometimes the patient’s family [member] is an expert in the patient. And it takes putting together both the medical judgment and the knowledge, the very in-depth knowledge about the patient, that leads to the right decision,” Winer said.

Winer also points out that patients shouldn’t worry about “taking up too much time” or “upsetting the doctor.” In fact, the opposite is true. Saying what’s on your mind and expressing your concerns, such as pain, can help nurture a stronger relationship with your cancer care team.

“You want to have a trusting relationship,” he said.

Studies show that those who receive compassionate, patient-centered care and “feel they’re part of the team” tend to get better-quality care. 

“Patients who [have] strong partnerships have better overall outcomes, have shorter lengths of stay in the hospital, are more satisfied with their care, and just as a general rule seem to do better,” Winer said.

That’s because you’re more likely to feel that you are heard and understood about what you value. 

This can include having clarity about your legal rights, your or your loved one’s role in decision-making, and the interactions you have within a health care setting. 

The trust you build with your doctor can also help when you make a difficult decision, such as enrolling in a clinical trial or other types of research. 

A clinical trial is a type of care you get in a research setting where doctors try out new tests, treatments, or procedures against the standard treatment. These are done on a volunteer basis. 

This helps researchers figure out if the new drug or treatment is better or more effective than the existing one. For example, the experimental drug might have fewer side effects or simply work better or faster. 

Clinical trials are well-researched and carefully reviewed before you can join one. But there’s still risk involved. 

That’s because your doctors might not be able to predict how well you’ll react to the new treatment. And if the trial is randomized, you may or may not get the newer treatment as part of the study design. 

“If [a doctor] wants a patient to consider participating in a clinical trial or other research studies, it’s really important that that patient understand just what that research is about, what the clinical trial is about, and that all comes from effective partnering,” Winer said.

Even though you might build a close relationship with your doctor, Winer said you don’t need to be “friends” with your doctor. Instead, focus on being proactive about what works for you and advocating for your particular needs.

“I think what makes a good partner is communicating clearly, listening, responding, respecting,” said Winer.

There are many types of cancers and subtypes of tumors. Treatment may differ for each type and change based on how widely it has spread inside your body. It can take time to make the treatment choice that fits your lifestyle needs. To make an informed decision, you might want to learn everything you can about it first. 

For example, if a certain treatment will require a lot of time and pull you away from spending time with your kids or other loved ones, you might want to explore an alternative. For this, you’ll need to speak honestly with your doctor. They can then help you weigh the risks and benefits of available options and find one that works best for you. 

Here are some things you can do to help build a solid rapport with your doctor:

• Prepare for your doctor’s visit. Take a few minutes to gather all your documents, write down any new symptoms or side effects, and note changes in medication or insurance. 

• Bring a list of questions. Doctor appointments are often short. To make the most of it, write down all of your questions on your phone or paper. Ask the most important ones first.  

• Bring a loved one to your appointment. If you’re worried or feel overwhelmed by the cancer care process, feel free to bring someone who can help advocate on your behalf. They can also help you make decisions if you’re not able to make them. 

• Be honest with your doctor. Don’t hold back on expressing your thoughts or worries. This includes being upfront about any lifestyle habits such as smoking or drinking alcoholic beverages, or side effects of treatment like lack of appetite or sleep changes. These things can affect the quality or effectiveness of your treatment. 

• Ask questions to properly understand your care plan. Whether it’s getting your lab tests, having blood draws, or scheduling chemotherapy appointments, make sure you understand each step of your care plan. If you don’t, have your doctor or other members of your care team explain. 

• Follow your care plan closely. Most cancer treatments are tailored to match your needs. Stick to the plan, but let your doctor know if a part of it, such as your medication dosage or a recommendation to quit smoking, doesn’t work for you. Your care team may be able to offer alternative options that work better for you.