Communication in Cancer Care in Asia: A Narrative Review

Mori, Masanori; Lin, Cheng Kuan; Cheng, Shao‐Yi; Suh, Sang-Yeon; Takenouchi, Sayaka; Ng, Raymond; Chan, Helen Yue Lai; Kim, Sun Hyun; Chen, Ping-Jen; Yuen, Kwok-Keung; Fujimori, Maiko; Yamaguchi, Takashi; Hamano, Jun; Kizawa, Yoshiyuki; Morita, Tatsuya; Martina, Diah

doi:10.1200/go.22.00266

Cited by 6 publications

(3 citation statements)

References 87 publications

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“…9 In recent years, cancer care communication preferences of Asians, including Filipino patients, have gradually shifted towards more open communication, partly due to the effects of globalisation of liberal values (freedom, autonomy and choice). 34 However, only a small proportion of our patients (3%) were prognostically aware (ie, aware that the current treatments they are taking for their cancer will not cure them). This is below the 56.2% (median=66%) of prognostically aware patients from studies conducted in Asia from a recent systematic review by Ng and Ozdemir.…”

Section: Comparison With Other Studiesmentioning

confidence: 84%

Cancer patients’ awareness of extent of disease: anxiety, depression, quality of life

Manalo,

Yang,

Reandelar

et al. 2023

BMJ Support Palliat Care

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ObjectiveIn Asian cultures, the belief that full disclosure would harm the patient’s health would lead to non-disclosure. The study aimed to determine whether making patients aware of the extent of their disease will lead to psychological morbidity and poor quality of life (QOL).MethodsThis was a cross-sectional study among 195 patients with stage 4 cancer who were aware of their cancer diagnosis at the medical oncology, radiation oncology and palliative care units at an academic cancer centre. Participants were asked about their cancer stage, treatment goal and if they prefer to know their life expectancy. They answered the 14-item Hospital Anxiety and Depression Scale and 27-item validated Functional Assessment of Cancer Therapy-General questionnaires. Determination of the association of patients’ awareness of the extent of the disease with psychological status and QOL was analysed using univariate and multivariate statistics.ResultsAbout three-fourths of patients with cancer knew they had an advanced disease, but very few were aware that the current treatments they were taking for their cancer would not cure them. No association between awareness of the extent of the disease and psychological morbidity was found. Still, those aware of the advanced disease had significantly higher QOL scores for social well-being.ConclusionsThis study revealed that physicians should not hesitate to communicate the cancer diagnosis and prognosis to patients, as the disclosure was not associated with psychological morbidity. Open communication between physicians, patients and their families on the extent of the disease could empower patients to make informed decisions about their treatment, engage in advance care planning and seek the necessary support.

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Section: Comparison With Other Studiesmentioning

confidence: 84%

Cancer patients’ awareness of extent of disease: anxiety, depression, quality of life

Manalo,

Yang,

Reandelar

et al. 2023

BMJ Support Palliat Care

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“…Particularly in Japan, patients traditionally do not desire autonomy for death or are willing to leave decision-making to their families (so-called ‘family-centered decision-making styles’) ( 88 , 89 ). Presumably, conversations and discussions based on the premise of death are not widely acceptable amongst the Japanese population ( 90 , 91 ).…”

Section: Challenges Of Advance Care Planning From the Perspective Of ...mentioning

confidence: 99%

The trajectory of prognostic cognition in patients with advanced cancer: is the traditional advance care planning approach desirable for patients?

Hasegawa,

Okuyama,

Akechi

2024

Japanese Journal of Clinical Oncology

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Most patients with advanced cancer initially express a desire to be informed of their prognosis, and prognostic discussions between patients and their oncologists can trigger the subsequent trajectory of prognostic cognitions. On the continuum of prognostic cognition, including inaccurate/accurate prognostic awareness (awareness of incurability of cancer, terminal nature of illness or life expectancy) and prognostic acceptance (accepting one's prognosis), patients’ perceptions of being informed of their prognosis by oncologists and patients’ coping strategy for serious medical conditions regulate prognostic cognitions. However, nearly half of the patients with advanced cancer have poor prognostic awareness, and few patients achieve prognostic acceptance. These phenomena partly act as barriers to participation in advance care planning. When oncologists engage in advance care planning conversations, they must assess the patient’s prognostic cognition and readiness for advance care planning. Considering the inaccurate prognostic awareness in a non-negligible proportion of patients and that astatic patients’ preferences for future treatment and care are influenced by prognostic cognition, more research on decision-making support processes for high-quality and goal-concordant end-of-life care is needed along with research of advance care planning. In addition to making decisions regarding future medical treatment and care, oncologists must engage in continuous and dynamic goal-of-care conversations with empathic communication skills and compassion from diagnosis to end-of-life care.

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“…Patients need to be monitored closely for adverse events (e.g., extrapyramidal side effects) and agitation control. For patients with refractory agitation, continuous deep palliation sedation (e.g., midazolam infusion) may be required after a thoughtful discussion with family [64]. [61,62], it may be reasonable to look for and treat any potentially reversible causes [23,24].…”

Section: Clinical Practicementioning

confidence: 99%

Pharmacologic Management of End-of-Life Delirium: Translating Evidence into Practice

Hui,

Cheng,

Paiva

2024

Cancers

Self Cite

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End-of-life delirium affects a vast majority of patients before death. It is highly distressing and often associated with restlessness or agitation. Unlike delirium in other settings, it is considered irreversible, and non-pharmacologic measures may be less feasible. The objective of this review is to provide an in-depth discussion of the clinical trials on delirium in the palliative care setting, with a particular focus on studies investigating pharmacologic interventions for end-of-life delirium. To date, only six randomized trials have examined pharmacologic options in palliative care populations, and only two have focused on end-of-life delirium. These studies suggest that neuroleptics and benzodiazepines may be beneficial for the control of the terminal restlessness or agitation associated with end-of-life delirium. However, existing studies have significant methodologic limitations. Further studies are needed to confirm these findings and examine novel therapeutic options to manage this distressing syndrome.

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Communication in Cancer Care in Asia: A Narrative Review

Cited by 6 publications

References 87 publications

Cancer patients’ awareness of extent of disease: anxiety, depression, quality of life

Cancer patients’ awareness of extent of disease: anxiety, depression, quality of life

The trajectory of prognostic cognition in patients with advanced cancer: is the traditional advance care planning approach desirable for patients?

Pharmacologic Management of End-of-Life Delirium: Translating Evidence into Practice

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