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Turning the Key

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A cancer diagnosis and accompanying explanations about tests and treatments can be overwhelming.

Bioethicist Rebecca Pentz, professor of hematology and medical oncology in research ethics at Emory, and colleagues have discovered that simple metaphors are helpful in explaining molecular testing to cancer patients. Pentz's team evaluated 66 conversations between oncologists and patients at Winship Cancer Institute. In 25 of the conversations, patients reported hearing a metaphor. One example:"For this cancer, the food was estrogen and progesterone. So we're going to focus on blocking the hormones because that way we starve the cancer of its food."

Other metaphors used by doctors included: bus driver, battery, circuit, broken light switch, gas pedal, key opening a lock, and traffic jam. Of the patients asked about the metaphor, 85% said it was useful and were able to demonstrate better understanding. "Metaphors provide a common language," says Ana Pinheiro, an Emory medical student who worked on the study. "The more grounded and straightforward the metaphor, the more likely patients are to follow along and understand." The study was published in The Oncologist.

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