Oncologists' communication about tobacco and alcohol use during treatment for esophagogastric cancer: a qualitative observational study of simulated consultations

Danique W. Bos-van den Hoek, Lois F. van de Water, Pieter G. Vos, Meeke Hoedjes, Ruud Roodbeen, Bastiaan R. Klarenbeek, Debby Geijsen, Ellen M. A. Smets, Hanneke W. M. van Laarhoven, Inge Henselmans*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

PurposeTobacco and alcohol use influence cancer risk as well as treatment outcomes, specifically for esophageal and gastric cancer patients. Therefore, it is an important topic to discuss during consultations. This study aims to uncover medical, radiation, and surgical oncologists' communication about substance use, i.e., tobacco and alcohol use, in simulated consultations about curative and palliative esophagogastric cancer treatment.MethodsSecondary analyses were performed on n = 40 standardized patient assessments (SPAs) collected in three Dutch clinical studies. Simulated patients with esophagogastric cancer were instructed to ask about smoking or alcohol use during treatment. The responses of the 40 medical, radiation, and surgical oncologists were transcribed verbatim, and thematic analysis was performed in MAXQDA.ResultsOncologists consistently advocated smoking cessation during curative treatment. There was more variation in their recommendations and arguments in the palliative compared to the curative setting and when addressing alcohol use instead of smoking. Overall, oncologists were less stringent regarding behavior change in the palliative than in the curative setting. Few oncologists actively inquired about the patient's perspective on the substance use behavior, the recommended substance use change, or the support offered.ConclusionClear guidelines for oncologists on when and how to provide unequivocal recommendations about substance use behavior change and support to patients are needed. Oncologists might benefit from education on how to engage in a conversation about smoking or alcohol.
Original languageEnglish
Article number676
Number of pages13
JournalSupportive Care in Cancer
Volume32
Issue number10
DOIs
Publication statusPublished - 1 Oct 2024

Keywords

  • Cancer
  • Communication
  • Health behavior
  • Smoking
  • Alcohol
  • Prevention
  • SMOKING-CESSATION SUPPORT
  • AMERICAN SOCIETY
  • LUNG-CANCER
  • BEHAVIOR-CHANGE
  • RISK-FACTORS
  • DIAGNOSIS
  • HEALTH
  • BARRIERS
  • HEAD
  • CONSUMPTION

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