Healthcare professionals (HCPs) often face significant communicative and emotional challenges when announcing cancer progression and proposing new treatments. These consultations can lead to significant psychological distress for caregivers, patients, and HCPs, particularly when they involve breaking bad news or proposing potentially ineffective treatments. Delivering bad news may lead to depression, anxiety, and uncertainty in caregivers and patients, while also contributing to rumination, stress, and decreased well-being in HCPs. There is limited literature on the coping strategies used by HCPs when dealing with the delivery of negative news. Some methods are discussing it with family, briefing with coworkers, getting professional support, participating in resting, physical activity, and meditation. Other less flexible methods are substance abuse, emotional detachment, dark humor, and avoidance methods.
Cancer progression announcements (CACPs) differ from other types of bad news because they may occur multiple times and sometimes still include a curative intent. This study aims to investigate how HCPs manage and experience these complex consultations, with a focus on emotional responses, support systems, the role of family caregivers, and communication techniques.
This qualitative study investigated a socio-constructive method to examine how HCPs handle consultation to declare cancer progression and provide new treatment methods. The participants consisted of surgeons, nurses, and oncologists from 3 hospitals in France and Switzerland. The study chose participants from October 2022 to January 2023 by snowball and email sampling. A PhD candidate in health psychology performed the interview, which covered themes such as support mechanisms, caregiver management, emotional impact, and communication methods. The analysis used Braun and Clarke’s six-phase thematic analysis with an inductive method used by NVivo software. Coding was conducted independently by 2 researchers and supervised by another person, and the patient-partner checked the theme logic. Reflexivity was preserved by peer discussions and memo-writing.
A survey of 20 HCPs showed 6 main themes linked to cancer progression consultations. The context of consultations is impacted by the type of cancer, available treatment methods, and patient knowledge. HCPs found these consultations emotionally difficult, specifically when fewer therapy options are available. Pre-consultation includes analyzing patient data and interacting with interdisciplinary teams. Patients and their family caregivers often experience heightened anxiety. Communication may be hindered by time constraints, location, and environmental noise. HCPs emphasize empathetic and honest communication adjusted to patient needs by using methods like hope-focused dialogue and silence. Follow-up appointments are planned to evaluate the effectiveness of the new treatment. HCPs experience emotional isolation and fatigue, which highlights the necessity of constant communication, training, and emotional support. They promote team-based CACPs and secure space for emotional briefing and peer support.
The limitations of this study are a heterogeneous sample, geographical coverage, limits to the potential for further investigation, and methodological limitations. To increase patient-centered care and HCP wellbeing during these difficult consultations like CACPs, it is suggested to give team-based delivery of bad news, include integrated and mandatory communication training, and establish safe emotional support spaces.
This study highlights the importance of practical strategies and effective medical communication to improve CACP outcomes. HCPs assess cancer progression with less effect than the bad news, as it is a part of the care pathway and leads to a suggestion of curative therapy. Difficulties like mandatory training, desire to work as a team, and a secure listening space have to be faced. HCPs mainly use informal or private moments with coworkers and suggest that institutional solutions are insufficient. Additional study on the perspective of P&Cs is necessary.
Reference: Kolly J, Lelorain S, Lamore K. Cancer progression: how to announce it? The perspective of physicians and nurses. Humanit Soc Sci Commun. 2025;12:898. doi:10.1057/s41599-025-05061-x
