“Holding Hope for Cancer Patients with Serious Illness”

TheoryLab

When a cancer patient has a serious diagnosis, clinicians and families can struggle with how patients experience hope. Three distinguished palliative care physicians and researchers joined the podcast for a conversation about their recent paper in JAMA titled, “Holding Hope for Patients with Serious Illness” (https://jamanetwork.com/journals/jama/article-abstract/2784454). Drs. Abby Rosenberg, Robert Arnold, and Yael Schenker shared their own experiences treating seriously ill patients and talked about how we can navigate the tension between appreciating the potential therapeutic benefit of hope and being concerned about perceived unrealistic hopes: “Rather than being concerned that hope is either so fragile that it can be lost, or so powerful that it can overwhelm decision making, clinicians should remember that hope is protective, if not necessary, for managing serious illness. Holding complex, flexible, and diverse hopes enables patients to believe in the unlikely while simultaneously accepting the inevitable. The role of clinicians is to support both.” Abby Rosenberg, MD, MS, MA, is a pediatric oncologist and palliative care physician and researcher at the University of Washington, where she directs the pediatrics component of the Cambia Palliative Care Center, and Seattle Children’s Research Institute, where she directs the Palliative Care and Resilience Lab. She has an American Cancer Society Research Scholar Grant to study “Resilience Outcomes Among Adolescents and Young Adults with Advanced Cancer.” Robert M. Arnold, MD, is a palliative care physician, Distinguished Professor of Medicine, and Chief of the Palliative Care Section at the University of Pittsburgh. He previously served as a member of the American Cancer Society’s palliative care peer review committee. Yael Schenker, MD, MAS, is a palliative care physician, Professor of Medicine, and Director of the Palliative Research Center (PaRC) at the University of Pittsburgh. She is a past recipient of American Cancer Society research funding, which supported her study of “Primary Palliative Care for Patients with Advanced Hematologic Malignancies.” 3:27 - The therapeutic benefit of hope and why it’s helpful to patients and caregivers 5:12 – Why clinicians sometimes feel the need to “correct” a patient’s hope 8:56 – How physicians can address the tension of appreciating the potential therapeutic value of hope but being concerned about perceived unrealistic hopes 10:50 – On how physicians can help patients diversify and increase their hopes 6:24 – How they became interested in this topic and decided to explore this topic in a broader way 17:35 – Advice they would share with someone in medical school who might someday treat patients with a poor prognosis 19:03 – A message for caregivers of a patient with a terminal illness