Jennifer Armstrong, MD

Oncologists grapple with an element of psychological stress that relatesto the suffering their patients experience. Although this stress maynot be unique to oncology, it is profound. When these stresses becomeoverwhelming, they lead to physician burnout. It is important to understandwhat makes an oncologist feel successful, what coping strategieshelp combat burnout, and what adds to the process of renewal. Thedoctor-patient relationship plays an important role for many oncologistsin this regard, and communication skills are increasingly recognizedfor their importance in this arena. We outline several clinical scenariosthat pose particular challenges to oncologists. These include breakingbad news and the patient’s response to hearing bad news, transitions incare and offering end-of-life care, participation in investigational studies,error disclosure, complementary and alternative medicine, spirituality,family discussions, and cross-cultural issues. By highlighting therelevant psychosocial issues, we offer insight into, and tools for, anenriched dialogue between patient and oncologist. The doctor-patientrelationship can be viewed as the ultimate buffer for dealing with thehassles encountered in clinical oncology.