Communicating with relatives in cancer care

Relatives are omnipresent in cancer care and commonly accompany cancer patients to physician consultations, increasing the complexity of the resultant communication. Relatives can provide important collaborative history, support, and advocate for their loved one, as well as have their own needs addressed. Relatives may also desire to protect their loved ones, and challenges arise if they invite the clinician to collude in keeping secrets. Optimally including relatives in a consultation is a complex task. Specific skills—for instance, asking permission, using circular questions and offering summaries—can enrich triadic communication. When breaking bad news, strategies for three-person consultations that have been used in communication skills training deliver benefits to both patients and their relatives. The successful accomplishment of three-person consultations is one hallmark of the mature clinician. It requires skill and time, but can certainly promote optimal patient care.