Monthly Archives: January 2019

Uncertainty in cancer. This time it’s personal.

I thought very carefully about whether or not to post this blog because it is, as the title suggests, quite personal. I decided in the end it was a story worth sharing.

As oncologists and other medical professionals, we deal with uncertainty all the time. We know that even when the path forward is clear, outcomes for our patients can vary. A real challenge comes when we need to make a recommendation despite having only limited data to help guide our recommendation. This can result in multiple reasonable alternative recommendations. The patient may present with a unique health problem or have personal desires and goals that impact our interpretation of how available data applies to that patient. Health care professionals have experiences with other patients with similar scenarios that impact our perspective. The discussion with patients and their loved ones often starts at a very basic level given their limited prior knowledge. These discussions are often nuanced and time consuming given the complexity of the issues at hand. They require us to balance all of these uncertainties as we communicate to our patients our recommendations among various choices, all with the understanding that our recommendations will impact patient decisions and ultimately their lives. Doing so effectively is a large part of the art of medicine.

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