Abstract
This study is the first to examine the prognostic role of physician empathy in interaction with the type of consultation (TC) (TC, bad news versus follow-up consultations) in cancer patient survival. Between January 2015 and March 2016, 179 outpatients with thoracic cancer and a Karnofsky performance status ≥60 assessed their oncologist’s empathy using the CARE questionnaire, which provides a general score and two sub-dimensions: listening/compassion and active/positive empathy. Survival was recorded until April 2018. Usual medical, social and psychological confounders were included in the Cox regression. The median follow-up time was 3.1 years. There was a statistical interaction between listening/compassion empathy and TC (p = 0.016) such that in bad news consultations, higher listening/compassion predicted a higher risk of death (hazard ratio (HR) = 1.13; 95% confidence interval (CI): 1.03–1.23; p = 0.008). In follow-up consultations, listening/compassion did not predict survival (HR = 0.94; 95% CI: 0.85–1.05; p = 0.30). The same results were found with the general score of empathy, but not with active/positive empathy. In bad news consultations, high patient-perceived physician compassion could worry patients by conveying the idea that there is no longer any hope, which could hasten death. Further studies are warranted to confirm these results and find out the determinants of patient perception of physician empathy.
Highlights
Lung cancer is one of the most fatal types of cancer, with 30% survival at one year post-diagnosis of non-small cell lung cancer [1]
The main objective of this study was to study the prognostic role of patient perception of physician empathy in cancer patient survival
How physicians present the progress of the disease and its treatment to patients could play a major role in counteracting the potential helplessness/hopelessness of patients [10], which are associated with poorer prognosis [11,12]
Summary
Lung cancer is one of the most fatal types of cancer, with 30% survival at one year post-diagnosis of non-small cell lung cancer [1]. The role of patient perception of physician empathy in cancer survival has never been examined. The main objective of this study was to study the prognostic role of patient perception of physician empathy in cancer patient survival. As a major source of support for cancer patients, physician empathy may impact survival [9], perhaps especially in the context of informing patients on their disease progression. In such a personally meaningful context of receiving bad news, it is plausible that most patients attend carefully to the content and manner of the physician’s speech. Empathy is related to the hormone oxytocin [13], which has anti-proliferative, anti-metastatic and anti-angiogenic effects in some cancers [14]
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