Guiding Patients Through Shared Decision-Making in Breast Cancer Care

At the 42nd Annual Miami Breast Cancer Conference, Kelly Grosklags, a licensed clinical social worker and board-certified diplomate in clinical social work, sat down for an interview with CURE. In the interview, she emphasizes the importance of personalized care in breast cancer care, highlighting that each patient’s needs and preferences are unique.

By fostering open communication, oncologists can help their patients navigate treatment decisions while addressing their concerns, she emphasized, adding that oncologists must remain involved in difficult conversations to ensure patients feel supported throughout their cancer therapy.

Grosklags is a psychotherapist; the founder and chief executive officer of Conversations with Kelly; a Philanthropic Cancer Board Member, in Minneapolis, Minnesota; and a senior advisor at Brighter Days Family Grief Center, in Eden Prairie.

Transcript:

It is important for providers to know that each patient, each person, is an individual. What worked for your 10 o'clock appointment may not work for your one o'clock appointment, though it may be same diagnosis and same genetic makeup. So, how can [oncologists] help navigate [this diagnosis]? [They must] ask, for instance, what kind of information do you want? How often do you want to check in about this? They [must] get to know what it is their patient really wants. I also tell patients it's really important that you can change your mind. Maybe, when you're first diagnosed, you're so overwhelmed that you don't want to have these conversations, but then later on, as time goes on and you feel more grounded or comfortable in the situation, you may want to change your answer with the doctor. You [may] want to say, 'I want a lot more information than I wanted in the beginning.'

Oncologists, obviously, are a very important part of the wellness of a patient. How they can help navigate the treatment of breast cancer — or any cancer — is honestly asking questions of that patient, and then if they get to a situation they're not comfortable with. For example, maybe it's a spiritual component, then they can refer [the patient] to a spiritual person, a chaplain, a social worker or whoever that may be. The thing is, I don't ever want anybody on the team to ever feel like they are the sole responsibility for getting this patient through this experience, and I think we put a lot of pressure on ourselves...

[There is a thing called] perfect patient syndrome. This [encompasses] how patients show up and want to be seen as doing okay and they don't want to rock the boat. There's also the perfect provider syndrome, where we as providers can get into this space of 'I have to have all the answers. I have to be the one that fixes this. I have to do that,' and I don't think that's true.

I think if the oncologist can bring in the team, including the patient, and collectively having discussions about how to get people through difficult situations, it's really the best approach. However, I will say that that oncologist absolutely has to be part of the team, and the patients will feel abandoned by their providers if they're not part of those difficult conversations.

Transcript has been edited for clarity and conciseness.

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