Posted by on Sep 23, 2013 in Blog, Breast cancer, Colorectal cancer, Hodgkin's lymphoma, Leukemia, Lung cancer, Lymphoma, Melanoma, Multiple Myeloma, Non-Hodgkin lymphoma, Prostate cancer | 6 comments

Or Patient-Centered Cancer Care:  IOM’s recommendations

Last week, we looked at the recent Institute of Medicine’s report and wrote the post about “How the US Got Its Cancer Care Crisis“.

This week we get more practical. With specific recommendations you can use!

The general recommendations include:

(1) becoming engaged patients.

(2) ensuring an adequately  staffed, trained, and coordinated workforce.

(3) providing evidence-based care.

(4) learning health care information technology (IT).

(5) translation of evidence into clinical practice, quality measurement and performance improvement.

(6) addressing accessible and affordable care.


One of the most important sections of the report, from the patients’ perspective, relates to improving patient engagement and making cancer care more patient-centered and increasing the use of palliative care.

How does the report help with patient engagement?  It provides a list of questions for the patient to ask of their physician.  Here is a repost of this list.

Questions about Prognosis

  • What is the goal of treatment?  Is it directly treating the cancer or  improving my symptoms or both?
  • How long does the average person with this cancer live? (ask for a window and the most likely scenario)
  • How ill I feel?
  • What is my likelihood of a cure?
  • If I cannot be cured, will I live longer with treatment?  How much longers/
  • Will I feel better or worse?
  • Can I receive palliative care focused on the quality of my and my familiy’s life during my cancer treatment?
  • What options do I have if I don’t want to continue my cancer treatment?
  • When should I think about hospice?  Can I meet with a hospice now, when I am well?
  • How often should we check in about my care plan?

Questions about Treatment

  • Why are my treatment options?
  • Why do I need this treatment?
  • How does this treatment compare with other treatment options?
  • What things are likely to happen to me?
  • Am I healthy enough to undergo the treatment?
  • What are the risks and benefits of treatment?
  • Are there any side effects?
  • Will treatment make me feel better or worse?
  • How many times have you done this procedure?
  • What is the cost of this treatment?
  • What clinical trials are available?
  • What are the potential benefits of clinical trials?
  • Am I eligible to participate?
  • How do I enroll?
  • Which hospital is best for my needs?
  • Which clinicians will coordinate my care?
  • How do you spell the name of that drug?
  • Will this medicine interact with medicines that I’m already taking?


Questions About Advance Care Planning


  • Are there things I should be doing to plan ahead?
  • Draft a will?
  • Participate in advance care planning and decide on my advance directives?
  • Choose a healthcare proxy who can speak for me, if I am unable?
  • Address financial or family legal issues?
  • Appoint a durable power of attorney for financial affairs?
  • Establish a trust?


Questions about family psychosocial, and spiritual needs


  • Will you help me talk with my children?
  • Who is available to help me cope with this situation?

According to the report these questions were actually adapted from three sources AHRQ, ASCO and, and Harrington and Smith (2008).

What do you think?

From your personal experience or expertise, what do you think about the IOM’s list of questions? Anything to add/remove/update in these lists?