#LCSM

#LCSM Chat 4/21: Doctor Shopping in the Age of Social Media

The doctor-patient relationship is without a doubt a keystone of medical care.  This relationship is arguably most intense in the field of oncology.  For patients, few things are as life altering as a cancer diagnosis.  This is particularly true for lung cancer, given its poor survival statistics and the social stigma sometimes associated with the disease.  Thus, for many lung cancer patients, a surgeon or oncologist (sometimes both) become an incredibly important person for several months, if not years.  These doctors will gather the patients’ data, inform them of their diagnoses, administer their treatments, and on occasion, describe the expected duration of their lives.

Much has been made of the modern day ailments affecting the doctor-patient relationship.  Among other factors, constraints on physician time and increased demands for electronic documentation have eroded the face-to-face interactions shared between doctors and patients.  At the same time, this “personal touch” has perhaps become less important to patients armed with medical information and increasingly determined to participate in their own treatment decisions.  In this service-based model, patients utilize their doctors but may not absolutely depend upon them for decision-making.

So, how then, should the modern lung cancer patient go about choosing his or her doctor?  Should patients look for empathy and communication skills, or have technical skill and up-to-date knowledge become more important in this era of minimally invasive surgery and molecular based therapy?  How important is experience?  Does the hospital or hospital system matter?  Is it worth the effort to travel great distances for care?  Certainly all of these questions arise when a newly diagnosed lung cancer patient starts considering his or her options.  Patients now have multiple tools at their disposal to search for and review lung cancer doctors.  This includes websites and social media networks that offer physician grades and patient evaluations.  But how reliable are these sources of information?  Have doctors simply become service providers that can accurately be evaluated online?

With these provocative questions in mind, we will cover the following topics in our upcoming chat:

T1: What are the most important characteristics to look for in a lung cancer doctor?  How did you find your lung cancer doctor?

T2:   What circumstances (medical or personal) might prompt you to get a second opinion or change healthcare providers?

T3:   What online tools might help patients identify appropriate lung cancer healthcare providers?

T4:   How can we better evaluate doctors and disseminate that information to patients?

Arguably, the choice of physicians is among the most the important decisions a lung cancer patient will make.  Please join our moderator, Dr. Brendon Stiles, on Thursday, April 21, at 5 pm PT/8 pm ET, for this important topic.  Information on how to join the chat can be found on the “Participate” page of the #LCSM Chat website.

#LCSM Chat 4/7: Cancersplaining–navigating tough moments

communication

Lung cancer patients, caregivers, and healthcare providers face many tough moments in which communicating about cancer care can be difficult:

  • An acquaintance approaches a patient with an unproven herbal remedy that will CURE CANCER!
  • A spouse wants to express their concern over the patient’s symptoms, or emotions the caregiver is experiencing.
  • A healthcare provider believes a test the patient wants will not help them or will delay the start of treatment.

In some cases, the person attempting to share information may know less about the subject than the person they’re talking to, and risks being perceived as condescending. In other cases, the person sharing information may know more about the subject, but might not know how share in a way that’s comfortable for both.

Our #LCSM Chat on Thursday, April 7, 2016 at 5 pm PT (7 pm CT, 8 pm ET) will focus on how to communicate effectively and compassionately in some common situations—even when one might feel frustrated, angry, or ignored.

Topics we will discuss include:

  • T1: How can a cancer patient/caregiver kindly respond to well-meaning people who suggest unsolicited treatments?
  • T2: How can a caregiver start a useful conversation with their cancer patient about significant symptoms or emotions?
  • T3: How can a cancer patient or healthcare provider start an effective conversation about care preferences or clinical trials?
  • T4: How can healthcare providers compassionately explain to cancer patients why proposed test/treatment is not a good option?

We hope you’ll join moderator Janet Freeman-Daily on Thursday April 7, 2016. If you’re new to tweetchats, please read this primer on how to participate in #LCSM Chats.

How Can We Overcome Hurdles in Clinical Lung Cancer Research?


By H Jack West, MD

People with lung cancer today benefit from a growing range of new cancer treatments that provide the promise of dramatic and long-lasting responses. Whether refinements in our chemotherapy, new targeted therapies, exciting immunotherapy strategies, or other novel agents or combinations, the development of these advances is exciting and based on the completion of important clinical trials. The investigators running trials of novel agents, as well as the companies developing them and the research groups helping to manage them, are eager to enroll on these studies and learn results that can potentially define new effective treatment approaches. Patients and families, of course, are also often eager to gain access to the latest new ideas and therapies.

And yet, despite all involved parties wanting to move quickly, the process of completing clinical research can be maddeningly slow. Trials can take MANY months to be activated as they work through committees and multiple regulatory steps developed to protect patients, slowing the pace of this burdensome bureaucratic process to a crawl. Once opened, trials are looking for patients, patients are looking for trials, but in many cases the trials take longer than hoped to enroll and demonstrate results. Less than 5% of patients with lung cancer enroll on clinical trials, which slows progress and means that, for many real world patients, the clinical trial research findings may not apply.

This week, for our upcoming #LCSM chat on March 24th at 8 PM Eastern, 5 PM Pacific, we’ll focus on the challenges we face from the many different perspectives of the various members of the lung cancer community, from patients and caregivers to community-based enrolling physicians, as well as the investigators writing and developing trials. Only by identifying these obstacles can we explore creative ways to overcome them. With these concepts in mind, we’ll cover the following questions for our chat:

  • T1: Clinical trials are highly regulated now due to prior shortcomings. Is level of regulation appropriately safe or excessive?
  • T2: Are patients informed about trials? Do docs discuss them, or do pts need to press for info? Are they readily available?
  • T3: Are trials too restrictive in eligibility? Do patients feel requirements are fair or keep too many people from participating?
  • T4:  What could investigators +/or trial sponsors do to raise interest & feasibility of more patients enrolling on LC trials?

The pace of clinical trials being completed sets the pace for our future advances. While we’ve added many new treatments in lung cancer over the past several years, there are others on the horizon. We hope you will participate to discuss how we can accelerate the pace of clinical research that leads to the advances in the coming years.

Information on how to join the chat can be found on the “Participate” page of the #LCSM Chat website (https://lcsmchat.com/lcsm-chat/).

References:

Cancer Communication in the Social Media Age

Tapping into Twitter to help recruit cancer patients into #ClinicalTrials

Twitter: The Future of Clinical Trial Recruitment

HeroX Clinical Trial Innovations Prize

Trial Reach

Clinical Trials in Cancer, by Dr. Ramalingam: Trial Development

Learn About Clinical Studies (by the National Institutes of Health)