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Friday, 22 February, 2002, 11:43 GMT
Cancer doctors told 'talking helps'
A doctor and patient consultation (posed)
Doctors with the training improved their communication skills
Doctors could be better at giving cancer patients bad news if they had lessons in communication, according to the results of a study.

An improvement in such skills could also offer better health prospects for the patient, the authors suggest.

Cancer doctors who took part in a practical study involving a three-day course found they were better able to talk to patients.

It has prompted swift action by the government's Cancer Tsar, Professor Mike Richards, to pledge funds for a training strategy for doctors.


Issues surrounding cancer are frequently "complex and distressing", the study, funded by Cancer Research UK, suggests.

If that 10 minute episode is to tell somebody that they have cancer, the patient will remember the way that news was broken for the rest of his or her life

Peter Cardy

But discussion of these issues can be hampered by a lack of communication skills, it reveals.

Researchers already knew that despite their length of experience, clinicians found talking to cancer patients and their relatives could be difficult.

During the study, conducted by Professor Lesley Fallowfield and colleagues from the University of Sussex over five years, 160 cancer doctors took part from 34 UK cancer centres.

Some undertook the training course and some did not.

A total of around 2,400 patients participated in the study.

There were also two assessment periods, when six to 10 consultations were held consecutively with patients then videotaped with their permission.


The content of the course included role-play with simulated patients, group discussions, a structured feedback and a review of the videotaped consultations.

Researchers found that those who took part in the course had "substantially improved" communication skills.

Good communication between cancer doctors and patients is vital

Prof Lesley Fallowfield

Most doctors found the course enjoyable and relevant as well as being informative.

Doctors with the training were 34% more likely to use focused questioned, compared with non-attendees.

They were also more able to express empathy with the patient - 69%, compared to non-attendees.

'Rewarding consultations'

Also they had a lower rate of using leading questions and were 38% more likely to give appropriate responses to patients' comments.

Professor Fallowfield said: "Good communication between cancer doctors and their patients is vital because it can have a huge influence over patients' treatment and quality of life."

Professor Mike Richards, director Cancer Research UK
Prof Mike Richards: Study gives conclusive evidence

Poor consultation leads to "dissatisfaction" for both parties, she added.

Professor Richards has announced funds to launch a programme which teaches doctors how to communicate the bad news of cancer.

The course looks set to provide the model for a government training strategy.

The study has also been backed by the Macmillan Cancer Relief charity, which provides both doctors and nurses to care for those with cancer.

Chief executive Peter Cardy said: "The average consultation only lasts for around 10 minutes.

"If that 10 minute episode is to tell somebody that they have cancer, the patient will remember the way that news was broken for the rest of his or her life."

'Powerful position'

Training should be adopted for all front-line staff dealing with cancer sufferers and it should become part of the "mainstream culture of cancer care".

The charity offers training for healthcare professionals through its Macmillan Cancer Information and Support Centres across the UK.

Professor Fallowfield said she hoped the study could be used to support calls for better training - not just for undergraduates at medical school.

And she said the senior doctors in cancer medicine and surgery who felt that they had benefited from the courses were in " the most powerful position to lobby for the establishment of the sort of supportive clinical environments that permit the practice of good communication skills".

The report features in Friday's edition of The Lancet.

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