Patient-Clinician Communication: ASCO Guideline Update

ASCO Guidelines provide recommendations with comprehensive review and analyses of the relevant literature for each recommendation, following the guideline development process as outlined in the ASCO Guidelines Methodology Manual. ASCO Guidelines follow the ASCO Conflict of Interest Policy for Clinical Practice Guidelines.Clinical Practice Guidelines and other guidance ("Guidance") provided by ASCO is not a comprehensive or definitive guide to treatment options. It is intended for voluntary use by clinicians and should be used in conjunction with independent professional judgment. Guidance may not be applicable to all patients, interventions, diseases or stages of diseases. Guidance is based on review and analysis of relevant literature and is not intended as a statement of the standard of care. ASCO does not endorse third-party drugs, devices, services, or therapies and assumes no responsibility for any harm arising from or related to the use of this information. See complete disclaimer in Appendix 1 and Appendix 2 (online only) for more.

To provide guidance to oncology clinicians on using effective communication to optimize the patient-clinician relationship, patient and clinician well-being, and caregiver well-being.

ASCO convened a multidisciplinary panel of medical oncologists, hematologists, nurses, hospice and palliative medicine clinicians, and communication skills and advocacy experts to develop recommendations. Guideline development involved a systematic review of the literature and a formal consensus process. The systematic review encompassed systematic reviews and randomized controlled trials (RCTs) published from October 1, 2016, through January 16, 2025.

The systematic review identified 73 publications (54 systematic reviews and 19 RCTs). Included studies varied with respect to setting and the interventions and outcomes evaluated. Recommendations were developed using a formal consensus process. Draft recommendations underwent two rounds of consensus voting before being finalized.

Recommendations address core communication skills and tasks that apply across the continuum of cancer care, as well as specific topics such as discussion of goals of care and prognosis, treatment selection, end-of-life care, facilitating involvement of the patient's support network, and clinician training in communication skills. In addition, new topics addressed by this update include telehealth, interprofessional communication, and boundary setting. Recommendations are accompanied by suggested strategies for implementation. Full implementation of communication best practices will require that health systems provide adequate time, training, and support for clinicians.Additional information is available at www.asco.org/supportive-care-guidelines.