Rapid Fire Best of the Best Poster Oral Clinical Oncology Society of Australia Annual Scientific Meeting 2021

Effectively communicating comprehensive tumour genomic profiling results: Mitigating uncertainty for advanced cancer patients (#353)

Nicci Bartley 1 , Megan C Best 2 , Barbara B Biesecker 3 , Alana Fisher 4 , David Goldstein 5 , Bettina Meiser 6 , David M Thomas 7 8 , Mandy L Ballinger 7 8 , Phyllis Butow 1
  1. School of Psychology, The University of Sydney, Camperdown, NEW SOUTH WALES, Australia
  2. Institute of Ethics and Society, University of Notre Dame, Sydney, NSW, Australia
  3. Research Triangle Institute, Washington , District of Columbia, United States of America
  4. School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
  5. Medical Oncology, Prince of Wales Hospital, Sydney, New South Wales, Australia
  6. Psychosocial Research Group, University of NSW, Sydney, New South Wales, Australia
  7. Garvan Institute of Medical Research, Sydney, New South Wales, Australia
  8. St Vincent's Clinical School, University of NSW, Sydney, NSW, Australia

Aim

While somatic genomics testing provides hope for improvement in cancer morbidity and mortality by helping to identify specific pathogenic variants to guide therapeutic approaches, the complexity of genomics has the potential to introduce novel scientific, practical and personal uncertainties for patients.

The aim of this research was to understand advanced cancer patients’ experience of uncertainty when receiving comprehensive tumour genomic profiling (CTGP) results, and their perceptions of how healthcare provider (HCP) communication impacts uncertainty.

Methods

Thirty-seven semi-structured interviews with advanced cancer patients were conducted within two weeks of patients receiving CTGP results. Transcripts were thematically analysed, using an inductive approach.

Results

We identified three themes that illustrate patient experience of uncertainties when receiving CTGP results: 1. Type and degree of uncertainty fluctuates along with changing illness circumstances and the nature of the CTGP results; 2. HCPs’ co-ordination of care and communication shapes uncertainty, with immediate, clearer and simpler information promoting certainty; and 3. Patients felt that communicating results to reduce relatives’ uncertainty is important, with patients choosing the time and process for achieving this and desiring HCPs support.

Conclusion

Oncology patients are confronted with an array of uncertainties. If CTGP is to become routine clinical practice, clear, simple communication from HCPs about results and their implications will be crucial in reducing uncertainty. Awareness of potential uncertainties experienced by patients when receiving results, will assist HCPs to address uncertainties, reduce uncertainty where possible, and offer targeted support to patients struggling with uncertainty.