Shared decision-making in oncology – turning principles into practice

In an era marked by unprecedented access to information, patients are increasingly more informed than ever before.

This shift is transforming the dynamic between patients and healthcare professionals (HCPs) and in turn, the decision-making process about their care. Despite this, two elements remain key to these interactions: effective communication and an environment where open discussions are encouraged.

In the words of a patient with metastatic colorectal cancer (mCRC): “Communication is key no matter the situation. While conversations with clinicians can be overwhelming and potentially even intimidating, it is incredibly important that people receiving treatment feel empowered to share their priorities, feelings and preferences, so they fully understand their options and ultimately are able to make an informed decision about their treatment.”

This perspective, shared during a recent Takeda-led patient panel, was an important reminder to me on why shared decision-making is so essential. The benefits are well-established – patients who have participated in projects where shared decision-making is practised have usually been overwhelmingly positive about them – but on a deeper level, it’s as simple as feeling heard. As individuals, we all have unique preferences, differences and values that we want to be respected and acknowledged; understandably, this also applies when we are making decisions about our health.

For those navigating a cancer diagnosis, especially those with advanced disease, I would argue that shared decision-making has particular relevance and impact. Decisions about care can be complex, and not always linear: what matters most to a patient at the time of initial diagnosis may differ significantly from the patient’s priorities three months into treatment, or after a year. Balancing immediate needs against longer-term goals, such as fertility preservation, can also prove challenging. The stakes can feel high – and when there’s pressure to ‘make the right call’, it’s essential patients and their loved ones feel comfortable and able to make informed decisions about their care that is right for them and their circumstances.

But from our panel, it is clear that patients and their loved ones are still navigating how to make informed decisions about their care. Panel participants spoke about how the urgency to make treatment decisions adds additional pressure to an already stressful and emotional time. Coupled with an often complicated and evolving treatment landscape, there continue to be significant barriers in how patients receive and digest information. Finally, a lack of support for both HCPs and patients on how to navigate these conversations was highlighted as a significant factor across the panel.

To me, the insights from the panel emphasise my earlier point that communication is central to shared decision-making, and it’s clear that more needs to happen so both patients, caregivers and HCPs all feel empowered to navigate conversations around care. So how can companies like Takeda support shared decision-making to become a reality?

One example is an ongoing campaign undertaken by my colleagues in Italy called Words Matter. This initiative centres around equipping both patients and HCPs to feel empowered to have conversations around their care; at the centre of the project is a co-created ‘Emotional Dictionary’, which aims to build a common language between doctors, patients and caregivers, with the goal of fostering a better understanding and improving the quality of the relationship. Based on these insights, a position paper for key institutions has been developed, which outlines the actions that are needed to improve communications between patients and doctors in oncology.

Other efforts we are involved in include exploring means to enhance communications in a specific form of lung cancer in the UK, as well as more broadly working with patient groups to co-create resources that support patients to better understand the genetic make-up of lung cancer through informed conversations with their doctors.

It is clear that meaningful action on shared decision-making cannot be achieved alone, and working collectively will yield the greatest impact. For this reason, we are proud to partner with patient organisations, listen to HCPs and together co-create solutions to make shared decision-making a reality – with this approach continuing to act as the foundation for how Takeda is approaching some of the biggest challenges in oncology.

References are available on request.