Clinician Perspectives on Communication and Implementation Challenges in Precision Oncology

Abstract

Aim: To describe patient communication challenges encountered by oncology clinicians, which represent a fundamental barrier to implementing precision oncology. Materials & methods: We conducted three focus groups including breast, melanoma and thoracic oncology clinicians regarding their precision oncology communication experiences. Transcripts were reviewed and coded using inductive thematic text analysis. Results: We identified four themes: varied definitions of precision oncology exist, clinicians and patients face unique challenges to precision oncology implementation, patient communication challenges engendered or heightened by precision oncology implementation and clinician communication solutions and training needs. Conclusion: This study elucidated clinicians’ perspectives on implementing precision oncology and related communication challenges. Understanding these challenges and developing strategies to help clinicians navigate these discussions are critical for ensuring that patients reap the full benefits of precision oncology.

Lay abstract

‘Precision oncology’ has gained momentum as a term to describe cancer care that is optimized for an individual patient based on her/his unique characteristics. However, clinicians may encounter challenges with communication when delivering precision oncology care to patients and their families. We conducted three focus groups, or structured discussions, with breast, melanoma and thoracic oncology clinicians regarding their precision oncology communication experiences. Narrative transcripts of these discussions were analyzed by the research team to identify common themes. We identified four themes: varied definitions of precision oncology exist, clinicians and patients face unique challenges to precision oncology implementation, patient communication challenges engendered or heightened by precision oncology implementation, and clinician communication solutions and training needs. This study elucidated clinicians’ perspectives on delivering precision oncology and related communication challenges. Understanding these challenges and developing strategies to help clinicians navigate these discussions are critical for ensuring that patients reap the full benefits of precision oncology.

Keywords::

• cancer
• communication
• personalized medicine
• precision medicine
• precision oncology
• qualitative research

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.tandfonline.com/doi/suppl/10.2217/pme-2021-0048

Author contributions

JG Hamilton, SC Banerjee, PA Parker and JL Hay were responsible for study conception and design; JG Hamilton, SC Banerjee, SV Carlsson, J Vera, KA Lynch, L Sar-Graycar, CM Martin, and JL Hay were responsible for the acquisition, analysis, and interpretation of the study data; JG Hamilton, SC Banerjee, SV Carlsson, J Vera, KA Lynch, L Sar-Graycar, CM Martin, PA Parker and JL Hay were responsible for the drafting and revision of the manuscript, final approval of the manuscript for publication, and agree to be accountable for all aspects of this work.

Financial & competing interests disclosure

This work was supported in part by a cancer center support grant from the National Institutes of Health/National Cancer Institute to Memorial Sloan Kettering Cancer Center (P30-CA008748). JG Hamilton was further supported by a Mentored Research Scholar Grants in Applied and Clinical Research, MRSG-16-020-01-CPPB, from the American Cancer Society. SV Carlsson was further supported by a career development award from the National Institutes of Health/National Cancer Institute (K22-CA234400). CM Martin was further supported by a diversity supplement award from the National Institutes of Health/National Cancer Institute (R01 CA207442-03S1). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

This study was reviewed and approved by the Institutional Review Board of Memorial Sloan Kettering Cancer Center (MSK). The MSK Institutional Review Board approved this study as exempt research, thus verbal assent to participate was obtained from all study participants.

Additional information

Funding

This work was supported in part by a cancer center support grant from the National Institutes of Health/National Cancer Institute to Memorial Sloan Kettering Cancer Center (P30-CA008748). JG Hamilton was further supported by a Mentored Research Scholar Grants in Applied and Clinical Research, MRSG-16-020-01-CPPB, from the American Cancer Society. SV Carlsson was further supported by a career development award from the National Institutes of Health/National Cancer Institute (K22-CA234400). CM Martin was further supported by a diversity supplement award from the National Institutes of Health/National Cancer Institute (R01 CA207442-03S1). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.