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Michael D'Angelica, MD; Kathy Hirsch, PsyD; Howard Ross, MD; Steven Passik, PhD; Murray F. Brennan, MD

Arch Surg. 1998;133:962-966.

Background  Effective physician-patient communication has been correlated with patient satisfaction and improved outcome. Pancreatic cancer (PC) is a disease with an overwhelmingly poor prognosis that requires a complex level of communication and emotional support. Since the treatment of PC is often surgical, surgeons play a central role in the care of these patients.

Objectives  To assess the quality of long- and short-term surgeon-patient communication. To assess the role of the surgeon in the emotional support of patients with PC.

Design  Combined mail and telephone survey of a case series of patients who had undergone a pancreatic resection for PC.

Setting  Urban tertiary cancer referral center.

Patients  Forty-eight patients who underwent pancreatic resection for PC.

Intervention  Pancreatic resection.

Main Outcome Measure  Patient satisfaction.

Results  Forty-eight patients completed surveys for a response rate of 70%. Patients were extremely satisfied with the information provided by their surgeon before surgery and while in the hospital. However, 21% of patients reported an unexpected outcome of their operation and 27% had questions about their disease at the time of the survey. Patients were largely satisfied with the emotional support they had received while in the hospital and after discharge. The attending surgeon was the most commonly desired source of additional emotional support.

Conclusions  While surgeon-patient communication was extremely effective before surgery and during hospitalization, patients developed long-term questions and dissatisfaction after discharge from the hospital. Strategies to improve long-term support and communication would benefit a significant number of patients with operable PC. Surgeons play an important role in the emotional support of patients with operable PC.

From the Departments of Surgery (Drs D'Angelica, Ross, and Brennan) and Psychiatry (Dr Hirsch), Memorial Sloan-Kettering Cancer Center, New York, NY; and Oncology Symptom Control Research, Community Cancer Care Inc, Indianapolis, Ind (Dr Passik).

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