[Physician-patient relations and decision in oncology]

The doctor-patient relationship has evolved during the past decades. This is particularly prominent when the patient's participation to the medical decision is analysed. The interest of the patient includes his (her) autonomy for which it is necessary to inform about different possibilities of treatment before informed consent. However each patient has his (her) personal characteristics and thus different wishes to be informed and to participate to medical decision. Moreover, this wish may change along the evolution of the disease. Thus, patients must be asked about the kind of relationship they prefer with the physicians. In all cases even if this relation is good, two kinds of barriers remain which are technical and emotional. Except in rare cases, patient cannot understand all the numerous medical data which are taken into account for the decision. Furthermore, since he (she) is personally concerned, it is difficult for him (her) to judge objectively and to think about a future which is hopefully positive after immediate reactions or hazards due to treatment. But his (her) advice must be asked and taken into account by the physician along with other parameters to choose the best option for the interest of the patient.