Discussing potential recurrence after lung cancer surgery: Uncertainties and challenges

Eur J Cancer Care (Engl). 2018 Sep;27(5):e12870. doi: 10.1111/ecc.12870. Epub 2018 Jun 4.

Abstract

Patients with lung cancer who undergo surgery may potentially be cured. The resulting pathological staging gives an indication of 5-year survival and whether further treatment is recommended. To date, there is little research evidence regarding the way potential recurrence is communicated to patients by staff. This qualitative research used case studies to explore how information disclosure about possible recurrence was managed following lung cancer surgery and aimed to identify practice implications for clinical teams. Twelve patients were recruited and first postoperative surgical and subsequent oncology or follow-up consultations were recorded and transcribed. The perspective of the professionals involved in these clinics was ascertained through 30 in-depth interviews. Key themes in the data were identified using Framework Analysis. Recurrence risk was communicated to patients in a number of ways and levels of clarity and openness. Information provided by participants about early warning signs of recurrence varied. Findings indicate information provided was linked to the patient's prognosis and individual professionals' underlying communication approach. This study provides a unique insight into the views of lung cancer specialists regarding information disclosure and reveals the challenging nature and complexity of discussing recurrence following lung cancer surgery.

Keywords: case study research, UK; communication; information; lung cancer; recurrence risk; surgery.

MeSH terms

  • Aged
  • Attitude of Health Personnel
  • Communication
  • Disclosure* / standards
  • Female
  • Humans
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local*
  • Physician-Patient Relations
  • Professional Competence
  • Qualitative Research
  • Uncertainty