CHICAGO — Facing a cancer diagnosis can be one of the most stressful times for patients and their loved ones. When seeking a surgeon for treatment, providing emotional support and helping patients manage expectations are among the top areas of communication valued by patients, according to a new systematic review.
The research will be presented at the American College of Surgeons (ACS) Clinical Congress 2025 in Chicago, October 4-7.
“Surgical oncologists play a pivotal role in the care of patients with many types of cancer, often serving as the initial point of contact for health care delivery,” said Shruti Koti, MD, first author of the study and a resident in the department of surgery at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health in New Hyde Park, New York. “With this research, we sought to provide guidance for surgical oncologists on approaching these difficult and often complex conversations.”
While previous research has shown that effective communication between surgeons and patients can boost outcomes and motivate patients to follow through with treatment, very little research has investigated the patient perspective, the authors said. To analyze the existing data on patient perspectives in cancer care, researchers examined 2,402 studies using research databases. They identified 15 studies that met their inclusion criteria, which included both qualitative and quantitative studies.
Key Findings
Six overarching areas of communication were identified in the review:
- Emotional support, optimism, and surgeon demeanor: Patients valued surgeons who provided emotional support and optimism during office visits, balancing facts with empathetic language that considers the emotional weight of having a cancer diagnosis.
- Setting patient expectations: Patients valued care providers who helped them understand the long-term effects and risks of their treatment, and the impact on their quality of life.
- Use of communication aids or tools: Patients appreciated surgeons who used physical cues, such as sitting down with them or a pat on the shoulder, and communication aids such as pictures and pamphlets that explained their diagnosis.
- Shared decision making: While some patients preferred that the surgeon determine their treatment plan, other patients expressed a desire to have a more active role in choosing their treatment. This variability suggests that surgeons may want to take an individualized approach in determining how much patients want to be involved in their treatment decisions, the authors said.
- Prognosis and long-term outlook: Most patients wanted to know statistics about their cancer and expected outcomes; however, if the outlook was poor, patients generally preferred not knowing as many details about their prognosis, reflecting the difficulty care teams may face in balancing optimism with realistic expectations, especially for patients with more complex cancers.
- Office setting and team logistics: Patients preferred being part of a multidisciplinary team and knowing their surgeon was communicating with other team members, for example, a translator (if needed), a nutritionist, or a social worker.
“Going into this review, we had no idea whether patients wanted to see their surgeon use a very direct and fact-based approach, or if they preferred surgeons who were more hopeful, optimistic, and appeared invested in their emotional well-being,” Dr. Koti said. “We ended up finding that patients really look for emotional support from their surgeons, and they find a lot of value in surgeons sitting down and being upfront with them, but in a very hopeful way that maintains optimism.”
Dr. Koti added that while surgeons aren’t always trained in communication skills in the same way as they are for performing surgery, research like this helps to break down communication into concrete, manageable components that can be practiced and perfected, just like a procedural skill.
“Effective communication is crucial in patient care, and has been linked to improved patient outcomes, increased satisfaction, and better adherence to treatment,” she said. “Recognizing important domains of communication can help both patients and surgeons, as well as other members of the health care team, approach a common understanding.”
The review is limited by the relatively small sample size of 15 studies, few of which reported demographic information such as education level, income, and insurance status of the patients. Additionally, none of the studies reported how the surgeon’s characteristics, including age, race, and gender, impacted patient perspectives. Future studies will investigate how these factors may impact patient preferences for communication.
Study co-authors are Rachel Harvey, MD; Grace Wu, MD; Joon Sub Lee, MD; Julia Purchla, MD; Elaina Suridis, DO; Santiago Lopez, MD; Matthew J. Weiss, MD, FACS; and Danielle K. DePeralta, MD.
Disclosures: The authors have no relevant disclosures.
Citation: Koti S, et al. Six Domains of Communication: Findings from a Systematic Review of Patient Communication Preferences in Surgical Oncology, Scientific Forum, American College of Surgeons (ACS) Clinical Congress 2025.
Note: This research was presented as an abstract at the ACS Clinical Congress Scientific Forum. Research abstracts presented at the ACS Clinical Congress Scientific Forum are reviewed and selected by a program committee but are not yet peer reviewed.
