ASCO President on Patient-Doctor Relationships

Cancer has a talent for turning normal life into a spreadsheet you never asked to open: appointments, labs, scans, side effects, insurance calls, and a brand-new vocabulary full of acronyms that sound like airport codes. In the middle of all that, the most underrated “treatment” is the relationship you have with your oncology teambecause it’s the channel through which everything else flows: decisions, trust, hope, realism, and yes, the occasional “Wait… what did you just say?”

Over the last several years, ASCO presidents have repeatedly spotlighted a simple idea that sounds obvious until you live it: the patient-doctor relationship in cancer care works best as a partnership. Not a hierarchy. Not a one-way lecture. Not “Doctor knows best, patient nods politely.” In a major opening session at ASCO’s annual meeting, one ASCO president put it plainly: the relationship should be neither hierarchical nor unidirectionaland we need real partnerships to deliver the best care and to help patients feel confident about options like clinical trials.

So let’s translate that leadership message into something useful: what strong patient-doctor relationships actually look like, what gets in the way (spoiler: time and the internet), and how patients and clinicians can build a partnership that’s honest, practical, anddare we saysustaining.

What ASCO Presidents Keep Emphasizing (Without Needing a Megaphone)

1) Partnership beats “perfect information”

Oncology is complicated. Even with excellent guidelines, many choices involve trade-offs: side effects versus benefits, aggressive treatment versus quality of life, convenience versus intensity, “do it now” versus “watch and wait.” ASCO leadership has highlighted that the point isn’t to dump a firehose of facts on someone already having the worst week of their life. The point is to make decisions togetherbased on evidence and on what the patient values and can realistically do.

2) Trust is the bedrockand trust is built, not declared

Medical ethics and cancer-care quality frameworks consistently describe the patient-physician relationship as being grounded in trust. Trust grows when patients feel heard, when uncertainty is acknowledged instead of hidden, and when the clinician’s recommendations clearly connect back to the patient’s goals. Trust also grows when someone says, “I don’t know yetbut here’s how we’ll find out,” which is weirdly soothing in a world that keeps demanding certainty.

3) Communication is a clinical skill, not a personality trait

Many people assume “good communicators” are just born that way, like left-handed pitchers. But oncology communication guidelines and training programs treat communication as a set of learnable skills: agenda-setting, active listening, empathic responses, checking understanding, and discussing prognosis and goals of care without taking away hope. ASCO’s patient-clinician communication guidance explicitly frames effective communication as a tool to optimize the patient-clinician relationship and the well-being of patients, clinicians, and families.

Why the Patient-Doctor Relationship Matters More in Oncology Than Almost Anywhere

The decisions are high-stakes and often time-sensitive

Cancer care can move fastsometimes appropriately, sometimes alarmingly. When time is limited, a strong relationship helps teams focus on what matters most: the patient’s goals, the best evidence, and the safest plan for “real life,” not just “clinical trial life.”

Uncertainty is baked into the cake

Even in 2026, oncology is still full of “we can estimate, but we can’t promise.” Response rates, recurrence risk, survival curves, biomarker implicationsthese are probabilities, not fortunes in a cookie. Good relationships don’t eliminate uncertainty; they help patients carry it without feeling alone or misled.

The care team is bigger than one doctor

Patients may interact with medical oncologists, surgeons, radiation oncologists, nurses, advanced practice providers, pharmacists, social workers, genetic counselors, palliative care specialists, and more. A healthy relationship includes clarity on roles: who coordinates, who handles symptoms, who answers portal messages, and who to call at 2 a.m. when something feels wrong.

The Biggest Threats to Partnership (And No, It’s Not “Asking Too Many Questions”)

Threat #1: The internetboth hero and villain

ASCO leaders and oncology organizations have noted what patients already know: digital access brings both education and disinformation. Patients show up informed, confused, worried, and occasionally convinced a social media post knows more than their oncology team. A partnership approach doesn’t shame people for googling; it helps them sort signal from noise.

A useful rule: if a claim sounds like “doctors don’t want you to know this one weird trick,” it’s probably not a peer-reviewed miracle. Bring it anyway. A good clinician will say, “Let’s look at it together,” not “How dare you read words.”

Threat #2: Stigma and blame

Another ASCO presidential message has been explicit: patients deserve empathy and the best possible careno matter how they arrived in the clinic. That includes cancers linked to smoking, alcohol, HPV, obesity, or environmental exposure. Stigma shuts down honesty, and honesty is required for good care. Partnership means making it safe to tell the truth.

Threat #3: Burnout and administrative burden

Recent ASCO leadership communications have also pointed to a reality patients can feel but may not name: clinicians are drowning in administrative tasks, prior authorizations, documentation, and fragmented systems. Burnout can make even excellent clinicians feel rushed, less emotionally available, or perpetually behind.

This is not an excuse for poor communicationit’s a reason health systems must support it. Partnership is harder when everyone is tired. That’s exactly why ASCO and many institutions emphasize clinician well-being and team-based care: healthy teams communicate better.

What “Relationship-Centered” Oncology Care Looks Like in Practice

Start with an agendayes, even if you hate agendas

The most powerful sentence at the beginning of a visit is also the simplest: “Here are my top three concerns today.” Patients can do this. Clinicians can invite it. Agenda-setting prevents the classic “Oh, by the way…” at minute 19 of a 20-minute slot.

• Patients: write your top 3 questions on paper (or your phone). Bring it out. Use it.
• Clinicians: ask, “What’s most important to make sure we cover today?” and actually pause long enough for the answer.

Use shared decision making: match options to values

Shared decision making isn’t just “pick A or B.” It’s a structured collaboration: compare options, clarify benefits and harms, explore burdens (time, money, symptoms, travel), and then align the plan with patient priorities.

Sometimes shared decision making is straightforward (“Which regimen fits your goals and schedule?”). Sometimes it’s conflict resolution (“I want the most aggressive treatment, but I also cannot miss work or I lose housing”). Sometimes it’s meaning-making (“What does ‘quality of life’ mean to you right now?”). The best teams adapt the conversation to the kind of decision being made.

Build “teach-back” into the visit (without making anyone feel like they’re being quizzed)

Teach-back is when the clinician asks the patient to explain the plan in their own words to confirm understanding. It’s not a pop quiz; it’s a safety check. Patients can do a version too: “Just to make sure I got this right…”

Respond to emotion earlybecause emotion doesn’t wait its turn

In cancer care, emotion isn’t an interruption; it’s part of the data. Anxiety can block memory. Fear can change preferences. Sadness can look like “noncompliance.” When clinicians name emotions (“This is scary; it makes sense you feel overwhelmed”), patients often absorb information better. When patients name emotions (“I’m terrified of nausea more than the cancer itself today”), clinicians can treat what’s actually driving the decision.

Practical Tools Patients Can Use (Starting at the Next Appointment)

The “Ask Me 3” mini-script

If you can only remember three questions (because you’re human), many health-literacy programs recommend these:

• What is my main problem?
• What do I need to do?
• Why is it important for me to do this?

Question banks from trusted cancer organizations

National cancer resources commonly encourage patients to ask about: treatment options and why one is recommended; benefits and risks; side effects and when to call; fertility; clinical trials; second opinions; and how supplements might interact with treatment. If you’re thinking, “That’s a lot,” you are correctbring a notebook, a friend, or both.

Bring a “second set of ears”

A family member or friend can take notes, ask clarifying questions, and remember details that your stressed-out brain might file under “later, maybe.” Bonus: they can also remind you to eat something that isn’t a granola bar you found in your glove compartment.

Ask for a written plan

Cancer-care quality frameworks emphasize care plans and clear documentationbecause patients shouldn’t have to reconstruct a treatment strategy from memory like it’s a true-crime podcast. If you don’t get a summary, ask for one: “Could we write down the plan and the next steps?”

What Clinicians Can Do (That Patients Notice Immediately)

Say the quiet part out loud: “You’re the expert on your life.”

Patients can’t always judge the nuance of evidence. But they can judge whether a clinician respects their reality: caregiving responsibilities, transportation, finances, language, fear, fatigue, faith, and community support. When clinicians explicitly invite that context, patients feel like partners instead of problems.

Talk about prognosis and goals in a way that preserves dignity

Recent ASCO presidential messaging around the “art” of cancer care has emphasized the difficult skill of discussing how sick someone is, what outcomes are realistic, and what the patient wantsespecially near end of life. These conversations help avoid situations where patients receive highly toxic treatments without understanding their prognosis or having their goals honored.

Normalize palliative care early

Palliative care is not “giving up.” It’s specialized support for symptoms, stress, communication, and quality of lifeoften alongside active treatment. When clinicians introduce palliative care early as a standard part of good oncology, patients are more likely to use it and less likely to fear it.

Clinical Trials and Trust: Why Partnership Changes Participation

ASCO leaders have linked partnership to something very practical: clinical trials enrollment. Trials require trusttrust that the team will explain the purpose, the alternatives, the risks, the protections, and what participation does (and does not) mean for access to care. When the relationship is strong, trials feel like an informed choice. When it’s weak, trials can feel like a sales pitch.

If you’re a patient considering a trial, ask:

• What would my standard treatment be if I don’t join the trial?
• What extra visits, tests, and costs might come with the trial?
• What happens if I want to stop participating?
• How will side effects be monitored and managed?

Conclusion: The Relationship Is the Treatment Delivery System

The most advanced therapy in the world still has to travel through conversation: what it is, why it’s recommended, what it changes, what it costs, how it feels, and what matters most to you as a person. That’s why ASCO presidents keep returning to the same core message: cancer care works best when patients and clinicians build real partnershipsgrounded in trust, structured communication, and shared decisions.

Patients don’t need to become oncologists. Clinicians don’t need to become mind readers. But both sides can commit to a relationship that makes room for questions, emotion, uncertainty, and valuesbecause those are not distractions from cancer care. They are cancer care.

Experiences: What Partnership Looks Like When the Door Closes and the Visit Begins (About )

Experience #1: The “I Heard a Thing on TikTok” Appointment

A patient walks in with a phone full of screenshots and the kind of worry that doesn’t sit down politely. The video promised a “natural” cure and warned that chemotherapy is “toxic by design.” In a non-partnership visit, this becomes a power struggle: the clinician dismisses it, the patient feels shamed, and trust takes a hit. In a partnership visit, the clinician says, “Let’s look at what you found,” and then calmly separates claims from evidence. They explain what is known, what is uncertain, and why certain treatments are recommended for this cancer, at this stage, in this person. The patient leaves without feeling embarrassed for searching, and the clinician leaves knowing the plan is realisticbecause it’s built on honesty, not compliance theater.

Experience #2: The Stigma Story No One Wants to Tell

Another patient hesitates when the clinician asks about smoking history. There’s shame in the pause. A quick, judgmental tone would shut down the conversation. But the clinician remembers the ASCO message about empathy for stigmatized diagnoses and says, “Thank you for telling me. This helps me take better care of you.” Suddenly, the room softens. They discuss cessation support without blame, and they focus on the patient’s present needs: symptom control, treatment options, and what support looks like at home. The patient becomes more willing to report side effects, to admit when they’ve missed doses, and to ask for helpbecause they’re no longer protecting themselves from judgment. In oncology, that shift can be lifesaving.

Experience #3: The “I Can’t Do This Treatment and Keep My Job” Reality Check

A recommended regimen requires frequent infusions and long travel. The patient is a single parent with hourly work and no paid leave. In a one-direction visit, the plan quietly collapses later. In a partnership visit, the patient says, “I’m scared I’ll lose my job,” and the team treats that as clinical information. They explore alternatives, connect the patient with social work, discuss scheduling strategies, and consider whether a different evidence-based option better fits the patient’s life. The final decision isn’t “less serious.” It’s more precisebecause it’s deliverable.

Experience #4: The Goals-of-Care Conversation That Prevents Regret

A seriously ill patient is hospitalized repeatedly. The family believes more treatment always means more hope; the patient is exhausted and afraid. The clinician, trained to navigate difficult conversations, gently asks what the patient wants most: more time at any cost, or comfort and time at home, or a specific milestone. They explain prognosis in plain language and check understanding without brutality. Palliative care joins early, not as a handoff, but as added support. The family still grievesbut later they say, “We knew what was happening, and the plan matched what mattered.” That is not a small outcome. That is a relationship doing its job.