Communicating Bad News in Oncology Practice

Abstract

A good attitude, fine communication skills, and empathy of the oncologist play an important role in the coping and bereavement abilities of patients and their families. The present article explains the role of oncologists in communicating bad news to patients and their care providers. Breaking bad news is an emotionally difficult and unpleasant task for an individual. In the practice of oncology, bad news includes diagnosis of cancer, poor prognosis, recurrence of disease, unsuccessful treatment, irreversible side-effects or complications, or a sudden unexpected event leading to death. A number of factors like time constraints, inadequate experience, spiritual and cultural beliefs, personal attitudes, burn-out, and the fear of harming the patient or being blamed by him or her influences an oncologist’s communication skills when delivering bad news. Hence, any communication between an oncologist and the patient should be able to lessen the patient’s uncertainty for the future, improve the ability of the patient to act, and strengthen the relationship between the two. A six-step approach, called the SPIKES Protocol, which is the most popular and acceptable method of giving bad news has been described in detail in this article.