Two Advocate Aurora Health cancer clinics in Wisconsin have joined a clinical trial evaluating how to best help patients and their clinicians make decisions about breast cancer treatment.
The National Cancer Institute (NCI)-sponsored study evaluates two new approaches to support patient decision-making and patient-clinician communication about breast cancer treatment. Researchers are comparing the two new interventions, one for patients and one for clinicians, with the traditional approach to treatment following diagnosis for patients who are not in a study, which is to consult with their clinicians about the various treatment options.
“As cancer treatments improve, largely through advances in precision medicine, they tend to become more complicated to explain to patients,” said breast surgical oncologist Joseph Weber, MD, Advocate Aurora Research Institute’s principal investigator for the study. “Meanwhile, clinicians are asking patients to use this complex information to make numerous important decisions at a time when they are in a stage of crisis following their cancer diagnosis. In order to truly optimize precision medicine, clinicians must also enhance our patient-centered communication.”
Advocate Aurora will conduct the clinical trial at Aurora West Allis Medical Center and Aurora Medical Center Grafton as part of its National Cancer Institute (NCI) Community Oncology Research Program (NCORP), which brings clinical cancer trials to people in their own communities.
Patients enrolled in the study will be randomly selected to use one of two decision tool websites. Participants will then be asked to complete surveys about their treatment decisions about one month after surgery and again about nine months after joining the study. Some participants will also be asked to participate in one-on-one telephone interviews about their treatment decisions.
“Some previously developed decision-making tools to educate patients about their treatment options were modestly successful,” Dr. Weber said. “These tools, however, tended to deemphasize the role of clinicians in the process. They also didn’t properly account for the powerful effect of emotion on the patient’s decision-making, despite it being a very emotional time.”
Previous studies have found that patients tend to catastrophize their diagnosis, placing too much weight on what might happen in the future, which can lead to quick decisions favoring more extensive medical treatment that might not be necessary.
“A cancer diagnosis is quite traumatizing,” said Amit Acharya, PhD, chief research officer and system vice president for Advocate Aurora and the Research Institute. “Add in the fact that most patients’ lack understanding of the risks and benefits of today’s complex cancer treatment options, and it’s no surprise that patients often express preference for extensive treatment as a way of putting their minds at ease.
“Clinical trials such as this that evaluate decision-making tools that address these underlying emotional drivers may allow our clinicians to better help our patients process information about treatment options and manage their worry.”
The study, “Improving patient-centered communication in breast cancer: A RCT of a shared decision engagement system (SharES),” is led by the Alliance for Clinical Trials in Oncology, a research group that designs and conducts clinical trials, is part of the National Clinical Trials Network sponsored by NCI, and serves as a research base for NCORP.
To learn more about Advocate Aurora’s research, visit aurora.org/research.