Approaches to Shared Decision-Making for the Oncology Team: Webinar Series-Treatment Goal Setting in Metastatic Cancer

Video Transcription

Video Summary

This webinar focused on shared decision-making, goals of care, and communication for patients with metastatic cancer. Patient advocate Andrea spoke first, sharing her experience of being diagnosed with metastatic breast cancer at age 41 and describing how patients quickly enter a “medical vortex” where major decisions are made under stress. She emphasized that patients do want to participate in decisions, but often need time to build trust, process information, and understand risks and quality-of-life tradeoffs. Andrea stressed that clinicians should not assume a conversation alone equals effective communication, and should repeatedly revisit goals, values, side effects, and end-of-life issues over time. She also noted that family, friends, and community influences can strongly shape decisions, especially in communities of color.<br /><br />Dr. Tom LeBlanc then reinforced these points with research. He explained that patients and families want to be heard, value empathetic and honest communication, and often prefer a patient-centered style that includes open-ended questions, emotional acknowledgment, and clear explanations of options. He noted that clinicians often interrupt too quickly, miss opportunities for empathy, and focus too narrowly on code status rather than broader goals and values. He introduced shared decision-making as a collaborative process and described the COD framework: choice talk, option talk, and decision talk. Decision aids can improve understanding, reduce decisional conflict, and help patients choose treatments aligned with their preferences.<br /><br />In Q&A, both speakers emphasized that good communication does not necessarily take more time, and that end-of-life conversations should begin early, be revisited often, and often involve palliative care support.

Asset Caption

Andrea Hutton
Co-Chair, Information Task Force
Metastatic Breast Cancer Alliance
Community Manager, Breast and Prostate Cancer
PatientPower.info

Thomas W. LeBlanc, MD
Medical Oncologist, Palliative Care Physician, and Patient Experience Researcher
Associate Professor of Medicine and Population Health Sciences
Duke University, Durham, NC

We will discuss how to frame treatment and supportive care conversations for patients with metastatic cancer. Strategies to clarify patient goals, values, and preferences and integrate into the care plan will be emphasized.

Keywords

shared decision-making

metastatic cancer

goals of care

patient communication

patient advocacy

quality of life

end-of-life conversations

palliative care

decision aids

empathetic communication