Bridging the communication gap in foregut cancer: A qualitative exploration of patient and caregiver perspectives

Background: Effective communication between patients, caregivers and the healthcare team is essential in foregut cancer care, where treatment often involves complex, high-risk decisions. Despite its importance, patient and caregiver perspectives on communication remain underexplored, particularly in underserved populations. This study aims to identify barriers and facilitators to communication from the perspectives of patients with foregut cancer and their caregivers. Study design: This qualitative study involved semi-structured interviews at a safety-net and tertiary care center in the Southeastern United States. Interviews were recorded, transcribed, and qualitatively analyzed using inductive thematic and content analysis with NVivo 14 software. Intercoder agreement exceeded 90%. The study adhered to consolidated criteria for reporting qualitative research (COREQ). Results: Forty-five individuals (30 patients, 15 caregivers) participated. Four key communication barriers were identified: (1) information overload and lack of clarity, (2) lack of clear expectation setting regarding prognosis and treatment impact, (3) lack of acknowledgement of patient or caregiver concerns, and (4) perceived inconsistencies in communication among providers. Five facilitators were described: (1) clear explanations using accessible language, (2) written or visual materials, (3) feeling heard, (4) opportunities to voice personal goals and concerns, and (5) presentation of treatment options and alternatives. Conclusion: Patients with foregut cancer and their caregivers face significant communication challenges that may impact trust, decision-making and satisfaction. Clear, empathetic and consistent communication that integrates patient goals and clarifies expectations is crucial to enhance quality of care and support shared decision-making. Insights gained will inform strategies to enhance communication and improve patient-centered care.