Breast Cancer

Sharing the Decision

Edited by Anna Maslin and Trevor Powles

User-friendly approach to shared decision making in breast cancer
Addresses issues surrounding areas of uncertainty
A holistic approach covering the clinician, patient, partner, and breast care team

Breast Cancer

Sharing the Decision

Edited by Anna Maslin and Trevor Powles

Description

Of all cancers, probably breast cancer is one of the most emotive. Increasingly patients with breast cancer are participating in the surgical and/or medical decision about their treatment. This involvement raises ethical issues about the rights of patients and their ability to give an informed consent, concerns about the process of communication betwen the medical staff and the patient, and also issues about the psychology of not only the woman with breast cancer, but also the doctor. This book addresses these issues relating to shared decision making and in particular those areas where a choice of treatment option involves some degree of risk/benefit analysis. It covers the ethical principles and then looks at the evidence that women who wish to participate and who are fully informed and who have taken part in the decision making process regarding their treatment, and who have a positive attitude towards their illness, tend to do better in the long run. Appropriate experts have contributed sections on the different treatment options to provide a brief overview of the treatments available and highlight the issues that should be considered by the woman and the doctor in the decision making process. There is also a section on the patients perspective and vignettes throughout to illustrate dilemmas the paitent faces and the importance of communication. Written for the surgical, medical and clinical oncologists who deal with breast cancer patients and senior nurses in breast cancer units, this book will also be of interest to trainees practising oncologists, and the women themselves who are interested in the shared decision making process in oncology generally.

Breast Cancer

Sharing the Decision

Edited by Anna Maslin and Trevor Powles

Introduction
1:Sharing the dilemma — The patient's dilemma, The partner's dilemma
2:Ethics and Patient Access to Information
3:Clinical Effectiveness and Evidence Based Practice
4:Communication, Psychiatric Morbidity, Access to Information and Decision Making
5:Approaches to shared decision making
6:Sharing the dilemma: The Professional's Dilemma — The Breast Care Nurse, Breast Cancer Screening, Breast Cancer Genetics, Chemoprevention of Breast Cancer, Surgical Treatment Options, Medical Treatment Options, Radiotherapy
Resource Organisations

Breast Cancer

Sharing the Decision

Edited by Anna Maslin and Trevor Powles

Author Information

Edited by Anna Maslin, International Nursing Officer, Department of Health, England, and previously Senior Clinical Nurse Specialist, Breast Group, The Royal Marsden Hospital, London, and Trevor Powles, Consultant Medical Oncologist, Head, Breast Group, Royal Marsden Hospital, London

Contributors:

Dr Laura Assersohn, The Royal Marsden NHS Trust Breast Unit, Sutton, Surrey, SM2 5PT
Dr Angela Coulter, Executive Director, Policy and Development, The Kings Fund, London
Dr R Eeles, Clinical senior Lecturer & Honorary Consultant in Cancer Genetics and Clinical OncologyInstitue of Cancer Research, Cancer Genetics Unit, Sutton, Surrey
Dr R Given-Wilson, Consultant Radiologist, SW London Breast screening service, The Duchess of Kent Unit, London
Dr T Habeshaw, Consultant Clinical Oncologist, Beatson Oncology Centre, Glasgow western Infirmary
Prof A Maslin, International Nursing Officer, Department of Health, England. Formerly Senior Clinical Nurse Specialist, Breast Group Unit Manager, Royal Marsden, Institute of Cancer Research, London
G McPhail, University of Glasgow, Beatson Oncology centre, Dept Nursing and Midwifery studies
Dr T Powles, Consultant Medical Oncologist, Head of the Breast Group, Royal Marsden, London
A Skene, Consultant Breast Surgeon, Royal Bournemouth Hospital
Dr I E Smith, Head of Section of Medicine, Royal Marsden, London
Jan Secker Walker, Research Sister, Action against breast cancer, UCL Medical School, Department of Surgery, London formerly Honorary Clinical Nurse Specialist, Royal Marsden, London
Dr Maggie Watson, Consultant Clinical Psychologist, Psychological Medicine, Royal Marsden, Surrey

Breast Cancer

Sharing the Decision

Edited by Anna Maslin and Trevor Powles

Reviews and Awards

"It is very fashionable and politically correct to talk about informed choice and shared decision making when it comes to doctor/patient relationships. However in practice most clinicians only pay lip service to this deal. Anna Maslin's book 'sharing the decisions' sets the record straight and describes the theory and practice of the true integration of the patients values and priorities into making medical decisions that can have the greatest impact on the length and quality of life of the individual." - Professor Michael Baum, Royal Free and University College Medical School, University College London