Physicians Encouraged to Use Everyday Language with Prostate Cancer Patients

Physicians should take more time with patients and use lay terms when explaining the options, risks and benefits of prostate cancer treatment, said University of Alabama at Birmingham researcher Dr. Mona Fouad, MPH, organizer of Prostate Cancer Summit 2007. “We found out from our keynote speaker (Dr. Kerry Kilbridge, instructor at Harvard Medical School) that we really need to do a better job in explaining things to the patients,” Fouad said. “We use language that we think is lay because we (physicians) use it every day, but it’s not.” Kilbridge interviewed patients and found many did not understand terms such as “incontinence” and “urinary dysfunction,” Fouad said. “There are a lot of side effects to treatment, so the patients really need to understand what they’re getting into and try to make more of a collaborative decision because it impacts the quality of life and impacts their risk,” Fouad explained. “This was a message we wanted to get out to physicians, especially primary care physicians who refer patients to specialists, because those are the ones who stay with the patients and can really communicate with them.” Fouad urges physicians to use lay language to explain that the prostate-specific antigen (PSA) test “sometimes detects cancers, and sometimes it’s high and there is no cancer. Explain the risks, and if they decide they want to go for treatment, openly talk to them about the results of these treatments and their options.” “Give them more confidence of asking questions,” she said. “Just listen to the patients, get the patients to ask questions and repeat what they say because the patients may get intimidated and say ‘yes, yes, yes’ and then they walk out, but they don’t really understand.” Fouad said patients might not know which questions to ask, so she suggests that physicians provide low-literacy materials or have a nurse do exit interviews to prepare the patients for treatment. “I hope the physicians are sensitive to these things and at least ask the patient, ‘Do you know what I mean when I say “incontinence”? Tell me what you think that means.’ Because it’s a big decision when they make the treatment choices.” August 2007