Nearly half of physicians find that telling a woman patient that her breast cancer has recurred is the worst part of their job, according to a major survey reported at the European Cancer Conference this week (23-27 September; Barcelona, Spain).

The survey of 462 physicians from France, Germany, Italy, UK and US, provided unique insight into the impact of managing breast cancer on doctors working in the field. Results revealed that 41.8% found conversations with their patients that their breast cancer had recurred were the worst aspect of their work. Nearly three-quarters (72.0%) thought that telling a patient she has early breast cancer was easier than telling her she has a recurrence.

Dr Mark Lansdown, Consultant Surgeon at Leeds Teaching Hospitals NHS Trust, UK, said: “Informing a woman that her disease has returned is awful; the news is usually unexpected. Personally, I find this ‘moment of truth’ emotionally draining and it worries me to think about the impact the difficult aspects of my job might have on my well-being.” The survey showed that one-third of doctors took worries about patients who had recurred home with them.

Professor Lesley Fallowfield, Professor of Psycho-Oncology at Brighton and Sussex Medical School, University of Sussex, UK, warned that another, recent survey of UK specialist registrars working in palliative medicine, medical oncology and clinical oncology had shown that 25% suffered stress that could affect the care of their patients and more than one in ten showed clinically significant levels of depression.

Treatment strategies that minimised the risk of recurrence are essential, both for women with breast cancer and their doctors, Dr Lansdown suggested. “The good news is that there are treatments that reduce the number of recurrences, allowing physicians to have more positive our patients.” For example, data from the ATAC (Arimidex, Tamoxifen, Alone or in Combination) trial showed that postmenopausal women with hormone receptor-positive breast cancer treated with the aromatase inhibitor Arimidex (anastrozole) had 26% fewer recurrences compared to those randomised to tamoxifen. “These data show that we can improve patient outcomes, meaning fewer women have to hear that their early breast cancer has returned, noted Dr Lee Martin, Lead Clinician for Breast Services, University Hospital Aintree, Liverpool, UK.

— European Cancer Conference, Barcelona, Spain

Written by: Susan Mayor
Susan Mayor PhD, freelance medical journalist, London UK
Mayor at dircon.co.uk