Precision medicine in cancer care: Navigating complexity in the doctor-patient relationship
Precision medicine tailors treatment and predicts individuals’ disease risk and drug response. It is likely to have a huge impact, not least on clinical cancer care. Adding a layer of complexity to the doctor-patient relationship. A recent publication in BMC Medical Informatics and Decision Making explores this added complexity and emphasises the need for clear communication between physicians and their patients.
The study was conducted within the ONCOLOGICS project that is developing an AI-based decision-support platform to improve diagnostics, prognostics and therapy design for advanced-stage colorectal cancer. This will, in the end, improve the prognosis for these patients as well as the selection of patients for clinical trials. Moving from a ‘one size fits all’ approach to identifying individual therapy based on the unique genotypic and phenotypic characteristics of each tumour. Researchers at Uppsala University’s Centre for Research Ethics & Bioethics are investigating ethical issues within the field.
Precision medicine uses for example patients’ genes, environment and lifestyle to predict disease risk and drug response. All patients may not get the same treatment, because it will be, or already is possible to know which treatments suit which patients better.
With the development of precision cancer medicine, it is central to preserve the doctor-patient relationship. Specific concepts and themes related to precision medicine, like the distinction between genomic and gene expression can be difficult to explain and patients’ need to understand what to expect in terms of access, eligibility, effectiveness, to make informed decisions in relation to their treatment plan. According to the authors of the BMC Medical Informatics and Decision Making publication, clear communication between patients and their physician is key.
“Patients’ need to make health decision in a trustful relationship, which is where the lack of opacity to some precision medicine technology can be a problem, which puts more pressure on doctor-patient communication,” says Åsa Grauman, researcher at Uppsala University’s Centre for Research Ethics & Bioethics. “By being open and honest about uncertainties” she continues, while showing empathy for the patient, can foster a trustful doctor-patient relationship, despite the identified challenges.”
By Anna Holm Bodin
Grauman, Å., Ancillotti, M., Veldwijk, J. et al. Precision cancer medicine and the doctor-patient relationship: a systematic review and narrative synthesis. BMC Med Inform Decis Mak 23, 286 (2023). DOI: 10.1186/s12911-023-02395-x