Gaps in communication between cancer patients and healthcare providers: symptom distress and patients’ intentions to disclose

  • Valentina PenalbaEmail author
  • Teresa L. Deshields
  • Dean Klinkenberg
Original Article



Good communication between patients and healthcare professionals (HCPs) is an important contributor to patient well-being. Few studies have focused on the gaps in communication between patients and HCPs about symptoms. This study examined patients’ perspectives on symptom distress, intention to discuss symptoms, and actual symptom discussion in medical oncology visits.


This was a cross-sectional descriptive study. Ninety-four patients provided demographic and clinical information and completed the Memorial Symptom Assessment Scale. Patients also answered questions about their plans for communication—and after the visit, their actual communication—with their medical team about their symptoms.


Patients reported many symptoms by questionnaire; however, they did not plan to discuss—nor actually discussed—most of their symptoms with their HCPs. For all symptoms, fewer than 42% of patients with the symptom intended to discuss it (except for lack of energy and pain) and less than 50% actually discussed the symptom. For bothersome symptoms, less than 42% of those with the symptom intended to discuss it (except for lack of energy) and less than 40% actually discussed the symptom. Psychological symptoms were endorsed by 24–41% of patients, depending on the symptom; however, of those endorsing a symptom, most did not discuss it with an HCP.


Results of this study support the perception of communication gaps between patients and HCPs about symptoms. Better understanding of these gaps is needed to ensure that patient-centered care is delivered and that patients’ symptoms can be appropriately managed in oncology clinics.


Memorial Symptom Assessment Survey Cancer patients Medical communication Symptom reporting Symptom bother 



The authors wish to thank Michele Medici, Cassandra Arroyo, and patients at Siteman Cancer Center for their contributions to this project.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Siteman Cancer, Barnes-Jewish HospitalWashington University School of MedicineSt. LouisUSA
  2. 2.School of MedicineWashington UniversitySaint LouisUSA
  3. 3.Barnes-Jewish HospitalSaint LouisUSA

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