COMMUNICATIONS GUIDE

This Communication Guide corresponds to the instances of the icon to the left found in the
Stanford Health After Cancer course. We suggest you bookmark or download this document, keep
it for reference as you advance through the course and after you have completed it.

Case 1: Amelia Elicit the patient’s concerns. Listen attentively. Respond

1 empathetically.
“This is an exciting decision for you and your husband. Do you have any concerns or
questions about fertility or family planning that relate to your cancer treatment you
would like to discuss with me?” Eliciting your patient’s concerns is one effective way
of opening up the discussion. Offering to listen and to provide guidance establishes
a solid foundation for a collaborative relationship.

“These are all valid concerns. May I share some family planning resources with you as
Timecode: 04:09
well? These may help you and your husband evaluate your options.” Validating your
patient’s concerns is important and serves to convey your concern and respect for
her as a person.

Case 1: Amelia Validate emotions and show empathy.

2
"Waiting for results can trigger anxiety. Many patients have told me they
find it difficult to wait for test results. Is this also a concern for you?"
Normalizing the anxiety triggered by testing and waiting for test
results is soothing for patients and providing some tips for maintaining
calm may also be helpful. Showing you understand their perspective
through an empathic statement will put your patient at ease.
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3 Case 2: Bob A statement of partnership may provide comfort to patients dealing

with new symptoms and an uncertain future.
Bob has shared that treatment was rough and that he is still fatigued and asks you
if this is normal. Your response provided important information and also expressed
your support for Bob and interest in helping manage distressing symptoms
related to treatment. Connecting with patients AND providing evidence based
recommendations for managing symptoms after cancer is an important element in
caring for cancer survivors. In this case the PCP may find it helpful to connect with
Bob's team to review his lingering symptoms.
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Case 3: Seema Welcome questions warmly, as this helps create rapport and solidify
4 the partnership between patient and clinician.
Seema and her husband respond to her PCP’s encouragement to share their concerns.
They speak of sleepless nights, fear of cancer recurrence and physical symptoms
that are likely related to her new medication (anastrazole). The clinician can elicit
concerns by asking open ended questions, giving the patient time to respond and
acknowledging her husband’s perspective and worries. She can show support and
respect by listening attentively and helping her patient sort through her concerns and
Timecode: 01:11 then partnering with her to find a resolution for her symptoms.
COMMUNICATIONS GUIDE

5 Case 3: Seema Ask your patients what they fear. Tell them what you think is going
on. Negotiate a follow up plan that is reasonable for both of you and reassures the
patient.
Exploring your patients’ fears can help you understand their request for more testing,
or explain the source of a strong belief. Cancer survivors may insist on getting tests
that you think are unnecessary, when in fact they are looking for reassurance that
they are well. Tell them what symptoms to watch for and when to call you, and
remember that some may be hypervigilant about any and all physical sensations after
cancer, while others may ignore important symptoms that should be brought to your
Timecode: 04:08 attention and deserve a work-up.

Case 3: Seema Normalizing side-effects that are common but also may be
6 embarrassing provides a strategy for talking about sexual health.
Sexual dysfunction is a common symptom among cancer survivors. Sexual health
and intimacy are important elements of wellbeing, and many cancer survivors lament
the loss of physical relationships. Prior surgeries and radiation may impact body
image and function, especially for those with ostomies and for patients who received
radiation to sexual organs. Sexual dysfunction is common among men and women
receiving hormonal deprivation treatments for prostate and breast cancer. Opening
Timecode: 07:59 the discussion is important and meaningful, and may lead to specialist referrals.

7 Case 4: Richard Elicit patients’ preferences, concerns, and values, discuss the
pros and cons together, and respect patient autonomy when working through
testing and treatment options collaboratively, using a process of shared
decision-making.
Cancer survivorship begins at diagnosis and lasts a lifetime. Richard’s case
demonstrates how important it is for patients to feel they have a solid relationship
with their primary care physician. Richard is a person who likes to obtain data and
think through important medical decisions. Years ago, he opted for screening for
prostate cancer based simply on his age. He was later faced with a dilemma as it
appears that he could have been a candidate for active surveillance, but instead opted
Timecode: 02:58 for treatment. His primary care physician was a good partner during this process and
helped him sort through his priorities and concerns, and then supported him through
and after treatment.