Join Y. Luh, MD
Q: How do you include patients in their health care decision-making?
As a radiation oncologist, I have direct face-to-face interaction with patients throughout the care process, from the initial consultation to long-term follow up. These interactions ensure I cultivate lasting relationships with cancer survivors.
When my patients proceed with radiation therapy, their informed consent is the result of a shared decision-making process between the patient and physician.
My initial consult may involve a healthy 75-year-old who is referred to me to discuss the role of post-lumpectomy radiation therapy for her early-stage breast cancer. I review the mature clinical trial evidence showing the local control and potential overall survival benefit of adjuvant radiation, but I also help her appreciate the smaller absolute benefit in healthy women over 70 who go on endocrine therapy. I discuss the option of a shorter course of radiation using hypofractionation over three to four weeks as opposed to the classic six and a half weeks. After discussing the acute and potential long-term side effects of radiation, she feels comfortable making an informed decision.
When I see patients for palliative radiation to relieve symptoms such as pain, obstruction, or compression, I help them prioritize what matters most to them, whether that is pain relief, survival, or functionality level. Some patients choose to enroll in hospice with no further cancer directed treatment, while others may choose to receive a short course of palliative radiation.
Classically known as the therapeutic arm of radiology, radiation oncology is a field where we can celebrate the successes of those that we can cure and be thankful for palliative radiation’s ability to relieve suffering.
By Join Y. Luh, MD, radiation oncologist at Dr. Russel Pardoe
Radiation Oncology Center at St. Joseph Hospital in Eureka, Calif.