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Blog | Cancer Coaching Reflections & Resources
Why Decision Coaching Matters
Clinic time is short, choices are complex, and stress is high. Research shows recall is low and misunderstandings are common. A structured way to prepare—and to check understanding—helps people leave with clarity and a plan.
When time is tight, recall is low
If you’ve ever left an appointment thinking, “I can’t remember most of what was said,” you’re not alone. Classic research has found that patients forget a large share of medical information immediately after a visit, and a meaningful portion of what is remembered can be inaccurate. Stress, new vocabulary, and the pace of clinic workflows all play a role.
The time squeeze in oncology
Face-to-face time with an oncologist varies by clinic and country. Some settings run very short consults; others average closer to twenty minutes or more. Either way, those minutes vanish quickly into essential tasks—checking scans and labs, reviewing medicines, documenting the plan. What’s left for working through options, values, and next steps can feel thin.
Health literacy: most of us need clearer information
Health literacy is the ability to find, understand, and use health information. Even highly educated people struggle when they’re stressed, newly diagnosed, or learning unfamiliar words. That’s why many organizations recommend a “universal precautions” approach: use plain language with everyone, break ideas into small steps, and confirm understanding (for example, using a brief “teach-back”).
- Short sentences & everyday words: “take after food” beats “administer post-prandially.”
- One idea at a time: split instructions into steps.
- Confirm understanding: “Can you tell me in your own words what the plan is?”
A real-life example: “I didn’t know the chemo needed a special IV.”
Mrs. L, 72, lives alone. At her first visit she agreed to treatment and signed the consent form. She didn’t realize the medicine required a PICC line which meant a minor procedure, weekly dressing changes, and a small but real infection and blood clot risk. Transport was difficult; her daughter works days and buses are infrequent.
After the first phase, a maintenance treatment was proposed for several months—more travel and more time feeling tired. She also learned that after a stem cell transplant, daily medicines and frequent visits continue for a while. When we stepped back, she said: “If the chance of benefit is modest and the logistics are heavy, I need to think about what fits my life.”
Example story. Details changed to protect privacy.
Informed consent: more than a signature
Consent is truly “informed” when you understand, in your own words:
- The decision & timeline: what needs to be decided, and by when.
- Options: including active treatment, watchful waiting, and supportive care.
- Benefits, harms & uncertainties: the likely outcomes and what we don’t know.
- Values & logistics: how the plan fits your priorities, family, travel, costs, and other health issues.
“How effective is it?” — ask for numbers you can use
Effectiveness often depends on your personal risk and the specifics of your cancer. Two tips make the numbers clearer:
- Ask for absolute numbers. “Out of 100 people like me, how many benefit? How many have side effects?” (Relative numbers can sound big but mislead without context.)
- Expect uncertainty. Good decisions weigh trade-offs under imperfect information; it’s okay to ask what the range of outcomes looks like.
Real-life factors matter, too
Logistics
Transport, parking costs, time off work, and whether someone can come with you—especially if you live alone—can change what’s realistic.
Ongoing care
Some regimens add a maintenance phase. Ports/PICCs need ongoing care. Transplant pathways include daily medicines and frequent monitoring.
Where AI can help (used wisely)
New tools can translate medical jargon into plain language, summarize long documents, and help organize questions for your next visit. Early research suggests these tools can improve readability of patient materials, when clinicians remain in the loop and content is checked for accuracy.
Know-before-you-say-yes checklist
- IV access: Will I need a PICC or port? What are the risks and care steps? How long will it be in for? Any alternatives?
- Schedule: How long is initial treatment? Is there a maintenance phase? How often are visits?
- Aftercare: What daily medicines or monitoring might follow? How much does it cost?
- Home realities: Transport, support person, living alone—what’s my plan? Is parking free at the cancer clinic?
- Blood work: Can I have my blood draws at my local lab? Can my blood be taken from my PICC or port? Do I need to fast before?
- Numbers: Can you give me benefits and harms in absolute terms? Can you write it down my options so I can review it with my family? Do I fall into a category of patients that place me at a particular advantage or disadvantage (i.e. my genetics, ethnic background, other health conditions)
- After hours: If a symptom appears at night, who do I contact and how?
- Teach-back: Before I leave, I’ll repeat the plan in my own words to be sure I’ve got it.
- How many cycles of treatment do I need to have before you know it's working? How will you tell it's working?
Evidence at a glance: Studies on post-visit recall and accuracy; visit-length/time-pressure data; AHRQ Health Literacy Universal Precautions (teach-back, plain language); Ottawa Decision Support Framework & patient decision aids; risk communication best practices (absolute vs relative risk); and emerging research on AI readability. See Evidence
A Note on Writing
This reflection was crafted with the assistance of AI, then carefully reviewed, edited, and personalized to reflect my voice and experience. My intent in using this tool is not to replace the human touch, but to strengthen it—allowing me to bring together research, scripture, and lived experience in a way that is both thoughtful and accessible.
With you on your journey,
June Ng-A-Kein Founder, Present Help by June
June Ng-A-Kein
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