ASCO has updated its guideline on patient–clinician communication, providing recommendations on a range of best practices for explaining treatment options and goals of care, conversing with patients’ support networks, communicating among care team members, and setting boundaries.1
The update to the 2017 guideline adds key recommendations for telehealth, which has increased significantly since the COVID-19 pandemic and led to major changes in patient–clinician discussions. Although the fundamentals of effective communication have not changed, the Guideline Expert Panel wanted to provide additional actionable and practical recommendations as well as to address interprofessional communication, said Guideline Co-Chair Timothy Gilligan, MD, of the Cleveland Clinic Taussig Cancer Institute.
Timothy Gilligan, MD
“We wanted to address interdisciplinary care communication among providers and also the fact that cancer care involves teams of people, including patients and their caregivers,” he said. “It’s about communicating in a way that respects other people for who they are and where they are at, and I think we emphasized that more this time around.”
The updated guideline incorporates a new recommendation on setting boundaries and calls for health systems to provide adequate time, training, and support to clinicians for implementing communication best practices.
Making the case for communications best practices, the guideline highlights studies showing that communications training both increases patient experience scores and reduces provider burnout.2
Moreover, the guideline emphasizes research that found communication that is not tailored to patient needs or leaves them feeling unheard or unsupported leads to patient distress or other negative emotions; however, communication that conveys empathy, support, and respect for the patient and their wishes can enhance patient–clinician relationships and patient well-being.3-7
The guideline provides a set of core communication skills for clinicians to use with their patients and their support networks, and lays out four fundamentals of health care communication derived from the broader literature: (1) establishing environments that are conducive to collegial communication, (2) collaborating to set agendas, (3) actively fostering trust and collaboration, and (4) responding with empathy to verbal and nonverbal displays of emotion.
Calvin Chou, MD
“We felt it was important to explicitly state four universal pillars that apply to all health care conversations with patients, families, colleagues, and staff,” said Guideline Co-Chair Calvin Chou, MD, of the University of California, San Francisco. “We can’t be perfect every time, but we need to exert the effort to interact respectfully with everyone.”
Best Practices for Telehealth and Boundary-Setting
As a result of the evolving health care landscape following the COVID-19 pandemic, one focus of the guideline is to address how telehealth and virtual visits present new communication challenges, such as how clinicians should position themselves in both synchronous and nonsynchronous audio and video conversations.
Recommendations include ensuring safeguards for confidentiality, using active listening and empathic reflection techniques, and scheduling video visits over audio-only visits when possible.
Another area of focus in the guideline is on clinicians setting boundaries with their patients through communication. The new recommendations on boundary setting consider both the behavior of patients as well as the clinician’s ethical responsibility to maintain appropriate boundaries, Dr. Chou said.
The Expert Panel focused on not just interactions between patients and their clinicians, but also interactions between clinicians, patient-support team members, and oncology team members, he said.
An example of boundary-crossing behaviors might include patients requesting their clinician alters their medical paperwork. In this case, the guideline suggests that clinicians and team members consider their internal reaction and decide whether and how to address the situation, Dr. Chou noted.
Ultimately, the goal of the guideline is to enhance patient–clinician relationships and improve patient well-being. “Clinicians have the clinical expertise, but the patient has the expertise of having lived in their body. They know what their values are. Decision-making needs to take into account both the clinician’s and the patient’s expertise,” Dr. Gilligan concluded.
REFERENCES
1. Gilligan T, Bohlke K, Alpert AB, et al: Patient-clinician communication: ASCO guideline update. J Clin Oncol. Published online March 10, 2026.
2. Altamirano J, Kline M, Schwartz R, et al: The effect of a relationship-centered communication program on patient experience and provider wellness. Patient Educ Couns 105(7):1988-1995, 2022.
3. Westendorp J, Geerse OP, van der Lee ML, et al: Harmful communication behaviors in cancer care: A systematic review of patients and family caregivers perspectives. Psycho-Oncology 32(12):1827-1838, 2023.
4. Collet R, Major M, van Egmond M, et al: Experiences of interaction between people with cancer and their healthcare professionals: A systematic review and meta-synthesis of qualitative studies. Eur J Oncol Nurs 60:102198, 2022.
5. Pozzar RA, Berry DL: Communicating is analogous to caring: A systematic review and thematic synthesis of the patient-clinician communication experiences of individuals with ovarian cancer. Palliat Support Care 21(3):515-533, 2023.
6. Lelorain S, Gehenne L, Christophe V, et al: The association of physician empathy with cancer patient outcomes: A meta-analysis. Psycho-Oncology 32(4):506-515, 2023.
7. Collet R, Major M, van Egmond M, et al: Experiences of interaction between people with cancer and their healthcare professionals: A systematic review and meta-synthesis of qualitative studies. Eur J Oncol Nurs 60:102198, 2022.
Originally published in ASCO Daily News. © American Society of Clinical Oncology. ASCO Daily News, March 18, 2026. All rights reserved.
