Study aims to improve medical communication

by Yolanda Sly

Women living with cancer of the cervix, vagina or ovaries might have less energy and experience more pain than their doctor’s estimate, according to a study conducted at the University’s Women’s Cancer Center.
Peter Johnson, an assistant professor of obstetrics and gynecology, conducted the study to determine the accuracy of physicians’ perceptions of gynecological cancer patients’ physical and mental health. Johnson hopes some questions asked of patients in his study will be used by doctors in their practices. This could lead to improved communication between doctors and their patients, he said.
Dr. Jeffrey Fowler, who asked the questions to several of his patients, said the quality of a patient’s life is hard to measure. The perception of the emotional and physical pain felt by gynecological cancer patients can vary greatly between different doctors and patients. But it’s still important to try to gauge this pain because, “In some cases where survival may not be possible, the best we can do is improve the quality of life of the patient,” Fowler said.
The American Cancer Society estimates that in 1996 there will be more than 82,000 new cases of gynecological cancer and almost 27,000 lives will be lost to the cancer. All forms of gynecological cancer can be detected through pelvic exams and pap smears performed during annual physicals.
The University study is the first part of a larger investigation into the quality of life of gynecological cancer patients. It is funded by the Division of Gynecologic Oncology of the Department of Obstetrics and Gynecology, and is part of Johnson’s fellowship research. He presented the study at a gynecological oncology conference in San Diego at the end of May and hopes to publish it soon.
For his study, Johnson questioned 111 women visiting the University’s gynecological clinic for cancer and non-cancer treatments during a 10-week period.
The surveys questioned patients on the amount of pain they experienced and how it affected their lives during a four-week period. Questions focused on patients’ ability to accomplish everyday tasks.
“There are things a patient won’t tell their doctor directly,” Johnson said, “but through a questionnaire the doctor can find out this information.”
Also, physicians might not think to ask patients certain questions, he said.
“Some don’t feel that doctors are doing a good job,” Johnson said.
Ellen Kleinbaum, who participated in the study, said that although she doesn’t have problems with her doctor misinterpreting her quality of life, she thinks the study is important.
Kleinbaum, who has had chemotherapy several times, said she feels that after five years with the same doctor, she has a good relationship with him. “Personally (the questionnaire) didn’t change my treatment, but I think it could flag a problem,” Kleinbaum said. It gives patients the opportunity to express on paper problems that may not be discussed during a visit, she said.
Johnson is optimistic that these types of questions will be asked more often by doctors in the future. “Reviewing the quality-of-life data over time on various medical interventions will allow patients to make more informed choices on the treatment option that’s best for them,” he said.
“I think in time this type of questionnaire could become as commonplace as having one’s blood pressure and weight taken during doctor’s visits.”