Many physicians fear that patients are so overwhelmed by the emotional content of their situations that they are unable to truly comprehend their medical alternatives. For example, patients often experience strong emotions when they receive cancer diagnoses. Extreme emotions can interfere with good decision making. Patients with terminal metastatic cancers may be so afraid of dying that they grasp at nonexistent straws. Elderly patients with localized prostate cancer may be so distressed at the thought of cancer cells residing in their bodies that they will not even consider watchful waiting.

Clinicians should recognize, however, that emotions are not necessarily antithetical to optimal decision making. For example, neurologists have determined that many patients with frontal lobe injuries have completely intact reasoning abilities; they can process information about risks and benefits normally but make bad decisions about their lives. They make bad decisions because they lack emotional feedback to guide their decisions.21 In some contexts, in fact, intuitive gut decision making leads to better outcomes than highly reasoned decision making.22,23

Moreover, even when emotions interfere with optimal decision making, the emotions may still deserve a role in decision making. For example, imagine a patient who is prey to what decision scientists call an omission bias-, he would rather accept a 10% chance of some terrible outcome from natural causes than a 5% chance of the same outcome resulting as a complication of treatment because he believes he will blame himself for making a choice that leads to a treatment complication.24 Rationally speaking, a 5% chance of something bad happening is better than a 10% chance of the same thing happening. But if this person would truly torture himself if he experienced the complication following treatment, and would not do so if he experienced the outcome naturally, then he should probably not receive treatment.

Similarly, the need to maintain hope and provide accurate information is a central challenge to physician-patient communication in oncology.25,26 On one hand, patients report a strong desire to have physicians encourage hope and optimism about their cancer, often in settings where there is little chance of long-term survival.27 On the other hand, overly optimistic communication can lead to a misplaced focus on aggressive treatment and is often regretted by patients when they reach later stages of their illness.28 Furthermore, providing patients with accurate information about a prognosis with and without treatment is necessary for their participation in medical decision making. Concern about how best to balance accuracy and hope can lead many clinicians to avoid participatory decision making.29

10 Ways To Fight Off Cancer

10 Ways To Fight Off Cancer

Learning About 10 Ways Fight Off Cancer Can Have Amazing Benefits For Your Life The Best Tips On How To Keep This Killer At Bay Discovering that you or a loved one has cancer can be utterly terrifying. All the same, once you comprehend the causes of cancer and learn how to reverse those causes, you or your loved one may have more than a fighting chance of beating out cancer.

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