Tag Archive for: skin cancer
Dr. Silvina Pugliese: Why Is It Important for You to Empower Patients?
Dr. Silvina Pugliese: Why Is It Important for You to Empower Patients? from Patient Empowerment Network on Vimeo.
How can skin cancer care providers work to empower their patients? Expert Dr. Silvina Pugliese from Stanford Cancer Center discusses her approach to patient empowerment, healthcare professionals she partners with, and methods to help enable informed patient decisions.
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Dr. Ana Maria Lopez Why Is It Important for You to Empower Patients |
Transcript:
Dr. Pugliese:
I do think it is a great honor to care for patients, and I do think of it as my duty to empower patients or the way I think about it, to inform patients and allow them to come to their own conclusions and decisions based on the information that I provide. So the ways that I go about doing this are, first, I think it’s really important to establish a relationship with patients. I don’t have the fastest clinic visits, but I know a lot about my patients and they know a lot about me, and I do think that that relationship is a really important foundation for the trust that is needed in order to have a very secure patient-and-doctor relationship.
As part of that, I do listen to what patient concerns are, because I think that if we don’t identify what patients are fearful of, what they actually are very comfortable doing, if we don’t hear what their concerns are with certain treatments, then I think all the education that we do is really not going to be helpful if it doesn’t align with the patient’s treatment wishes and desires and what they’re comfortable doing. And then I provide information. So basically I will provide as much information as I have and know and always connect patients with someone who knows more than I do in their particular area of concern and who can provide information beyond what I know for certain situations. So often I will partner with other dermatologists, surgical dermatology, oncology, radiation oncology, medical oncology, surgical oncology, just to make sure that I have resources available for patients when they are making a decision.
So by doing those different things, I hope that I’m empowering my patients to feel better about their medical care, to feel like they are receiving the best medical care and to feel comfortable in making some really difficult decisions. It is important for me to do again, because I think that is my job, it’s my duty, I don’t take it for granted. And I think that it is the least that we can do when we’re being really entrusted with some very like vulnerable and personal information that patients are providing to us.
Becoming Empowered and [ACT]IVATED After A Non-Melanoma Skin Cancer Diagnosis
Patient Empowerment Network (PEN) is committed to helping educate and empower patients and care partners in the non-melanoma skin cancer community. Skin cancer treatment options are ever-increasing with new testing, treatments, and research information, and it’s important for patients and families to educate themselves with health literacy tools and resources on the latest information in skin cancer care. With this goal in mind, PEN initiated the [ACT]IVATED Non-Melanoma Skin Cancer program, which aims to inform, empower, and engage patients to stay abreast of the latest in skin cancer care.
The [ACT]IVATED Non-Melanoma Skin Cancer (NMSC) program is geared to newly diagnosed skin cancer patients, yet can be beneficial for patients at any stage of disease and for patient advocates. [ACT]IVATED helps patients and care partners stay updated on the latest options for their skin cancer, provides patient activation tools to help overcome barriers to accessing care and powerful tips for self-advocacy, coping, and living well with cancer.
Skin Cancer Disparities
There are important skin cancer risk factors and vital differences to know about how some skin cancers can look and where they occur in different populations. Mary Leer, a cancer survivor and empowerment lead at PEN interviewed Dr. Silvina Pugliese as part of the [ACT]IVATED Non-Melanoma Skin Cancer program. Dr. Pugliese discussed some skin cancer risks including occupational risks of those who work outdoors, at high altitudes like pilots and Air Force personnel or veterans, and older white men. Additional risk factors include those who have undergone solid organ transplant, arsenic in well water, smoking, chronic wounds, wounds or scars, genetic mutations, exposure to radiation, leukemia patients, living near the equator, freckles, and naturally blonde or red hair. Dr. Pugliese further shared about current or previous occupational risks, “…if you are within one of these occupational categories where you work primarily outdoors or have worked primarily outdoors, have had sunburns while working outdoors, have worked at high altitude, it’s important to have your skin checked, to make sure that you have not developed any spots that could be worrisome for non-melanoma skin cancer.”
The appearance of basal cell skin cancer and squamous cell skin cancer may often look different or occur in different locations in skin of color patients in comparison to white patients. It’s important for both patients and patient advocates to raise awareness about the key differences. Dr. Pugliese explained how more studies on squamous cell cancers have shown how locations may vary for non-white patients. “…We know that in skin of color patients we might see more of these skin cancers on the lower legs or on the feet or in genital or perianal skin. And that’s important, because we as dermatologists need to make sure that we’re examining all of these areas when we’re doing a full body skin exam. In addition, about 20 to 40 percent of all squamous cell cancers diagnosed in Black patients are occurring within scars or areas of chronic inflammation such as wounds.” It’s also important to note that squamous cell cancers are often advanced when they’re diagnosed, and so larger sections of skin are more often removed, which may have more long-term impact on the patient.
Basal cell cancer is the most common type of skin cancer and has a different appearance in skin of color patients. Dr. Pugliese explained the key differences in appearance and a rare tumor called Dermatofibrosarcoma protuberans (DFSP). “So it might have more of a purple or blue appearance than the classic pink shiny bump that we talk about. And then finally there is a rare tumor that we call DFSP that is actually more likely to occur in Black patients and can often have a scar-like appearance. This is a rare soft tissue tumor that can involve the deeper skin sometimes into the fat and even muscle.”
![Dr. Pugliese [ACT]IVATION Tip](https://powerfulpatients.org/wp-content/uploads/Screenshot-2023-06-06-at-4.28.48-PM-1030x556.png)
Solutions for Improved Skin Cancer Care
Patient education and empowerment are key parts on the path to informed and optimal care. These efforts can take many forms but include approaches like improving clinical trial participation, learning more from credible resources, asking questions to ensure your best care, and helping to educate others about skin cancer.
Clinical trial participation by diverse populations is especially important for the more rare types of skin cancer. Dr. Silvina Pugliese shared about the value that can be derived from research, “…we think about less common skin cancers like Merkel cell carcinoma or DFSP. And when we think about how uncommon these skin cancers can be in skin of color, we realize we’re really drawing from a very small pool of patients. So my point here is that you can make a true impact by enrolling in a clinical trial, especially as we’re looking at what are some of the best treatment options for these more advanced skin cancers or metastatic skin cancers? Because we do need the right patients to be enrolled in order to study these research questions.”
[ACT]IVATED Non-Melanoma Skin Cancer Program Resources
The [ACT]IVATED Non-Melanoma Skin Cancer program series takes a three-part approach to inform, empower, and engage both the overall lung cancer community and patient groups who experience health disparities. The series includes the following resources:
- Occupational Exposures and Non-Melanoma Skin Cancer: Understanding Risk Factors
- How Do Non-Melanoma Skin Cancers Impact Non-White Populations?
- Which Non-Melanoma Skin Cancer Treatments Are Available for Patients?
- Non-Melanoma Skin Cancer Subtypes | Are Some Populations More At-Risk?
- Explaining Skin Cancer to Newly Diagnosed Patients | An Oncodermatologist Weighs In
- Melanoma vs. Non-Melanoma Skin Cancer: What’s the Difference?
- Do Non-Melanoma Skin Cancers Differ in Diverse Patient Populations?
- Non-Melanoma Skin Cancers and Clinical Trials | Advancing Science for Everyone
- [ACT]IVATED Non-Melanoma Skin Cancer Resource Guide
- [ACT]IVATED Non-Melanoma Skin Cancer Resource Guide en español
Though there are skin cancer disparities and variation in location and appearance of skin cancer, patients and care partners can be proactive in gaining knowledge to help ensure optimal care. We hope you can benefit from these valuable resources to aid in your skin cancer care for yourself or for your loved one.
[ACT]IVATION Tip:
By texting EMPOWER to +1-833-213-6657, you can receive personalized support from PENs Empowerment Leads. Whether you’re a non-melanoma skin cancer patient, or caring for someone who is, PEN’s Empowerment Leads will be here for you at every step of your journey.
[ACT]IVATED Non-Melanoma Skin Cancer Resource Guide en español
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An Expert’s Perspective on Advanced Non-Melanoma Skin Cancer Research
An Expert’s Perspective on Advanced Non-Melanoma Skin Cancer Research from Patient Empowerment Network on Vimeo.
What’s the latest in advanced non-melanoma skin cancer research? Dr. Sunandana Chandra shares an update on emerging treatments and provides reliable resources for research news.
Dr. Sunandana Chandra is a medical oncologist and Associate Professor of Medicine at Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Learn more about Dr. Chandra.
Related Resources:
What Are Treatment Goals and Considerations for Advanced Non-Melanoma Skin Cancer? |
A Review of Current Advanced Non-Melanoma Skin Cancer Treatment Options |
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Transcript:
Katherine:
Are there developments in advanced non-melanoma skin cancer treatment and research that patients should know about?
Dr. Chandra:
So, you know, in the past, as a medical oncologist, we used to use a lot of chemotherapy.
So, these are drugs that are notoriously hard to tolerate. Patients, understandably, are fearful of them and many of them don’t want them. They’ve seen friends and family go through them. And frankly, they have not been the most effective or efficacious in treating non-melanoma skin cancers, traditionally. But in the past, that’s all we had.
Now, we actually have much better therapies, specifically, the category of drugs called immunotherapy drugs that really boost a person’s own immune system to fight the cancer. These drugs are fairly new in the cancer world, and certainly new in the non-melanoma skin cancer world, and so, many of our colleagues in the community may not necessarily think of them when they’re considering patients.
Perhaps, a lot of our patients haven’t even gotten a chance to hear about them. So, yes. There are new developments that I think are worth considering earlier and earlier in the course of a person’s treatment course. And so, I think an earlier referral to these multidisciplinary team members, including a medical oncologist, may not be a bad idea.
Katherine:
How can patients stay up-to-date on developing research? What’s available for them?
Dr. Chandra:
So, you know there are skin cancer patient advocacy websites that they can check out, skincancer.org. I always tell patients to be careful about what website they’re checking, because I certainly want them to go to a website that’s reputable, that’s vetted, that is something that we think has accurate information that’s evidence-based.
And so, AIM at Melanoma has a non-melanoma skin cancer educational website. It’s called SCERF, which is Skin Cancer Education and Research Foundation, and you can find that through the aimatmelanoma.org website. You can look at skincancers.org, you can try with American Cancer Society, or you can even ask your clinical care team and see if they have any suggestions. There’s a lot of resources out there. I would just urge our patients to be careful in what source they’re looking at just make sure that they’re getting accurate, evidence-based information.
Should Advanced Non-Melanoma Skin Cancer Patients See a Specialist?
Should Advanced Non-Melanoma Skin Cancer Patients See a Specialist? from Patient Empowerment Network on Vimeo.
Do advanced non-melanoma skin cancer patients need to see a specialist? Dr. Sunandana Chandra explains the benefits of working with a specialist, how she empowers patients, and when she recommends seeking a second opinion.
Dr. Sunandana Chandra is a medical oncologist and Associate Professor of Medicine at Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Learn more about Dr. Chandra.
Related Resources:
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What Are Treatment Goals and Considerations for Advanced Non-Melanoma Skin Cancer? |
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Transcript:
Katherine:
Why is it important that patients speak up and have a voice in their care?
Dr. Chandra:
Well, I think for person to feel empowered, they have to understand their cancer, in my opinion.
And that’s part of my responsibility is to try to share what I know about their cancer, my medical and clinical experience dealing with that type of cancer, and really, to try to empower them by giving them knowledge about their cancer, about their diagnosis, about the prognosis, about potential treatment options. And, I really think that that knowledge is really empowering for our patients and their family members, and I think with that knowledge, they can make the most informed decision, and they can help us then figure out what the best management plan for them is. You know, I try to spend a considerable amount of time with my patients and their family members and loved ones to explain all of this at the get-go so that that way, oftentimes, they can go home, they can kind of think about it, come back with more questions.
Or, if they do some additional research on their own, hopefully some of what I’ve talked about might resonate and might even spur on more questions that usually can be very helpful for us to try to answer, helpful for the patient, I mean.
Katherine:
Absolutely. Should patients consider seeing an advanced non-melanoma skin cancer specialist?
Dr. Chandra:
You know, for a “routine” non-melanoma skin cancer of which the most common are basal cell carcinomas, squamous cell carcinomas, they may be tiny spots, maybe one, potentially multiple, that can just be excised and the person can be followed closely. For them, perhaps seeing someone locally, maybe very reasonable.
But, if the patient themselves is ever worried or unsure, or they feel like they want to see a specialist, I absolutely would encourage that. In addition, for a person who has recurrent non-melanoma skin cancers, you know, multiple occurrences, maybe even more advanced than others, I think that those particular patients going to a specialist or a number of specialists may really help with the most advanced care. Maybe it’ll allow the patient and their team to be more proactive, maybe allow for other options that are maybe not standards of care, maybe novel, but promising.
And so, I think for patients who are worried or for patients with more high-risk features, more increased number of skin cancers, perhaps more advanced skin cancers, I think having an expert or a team of experts on their team is certainly worth considering.
Katherine:
What is your advice for patients who may feel like they’re hurting your feelings by seeking a specialist or a second opinion? Any advice for self-advocacy?
Dr. Chandra:
Oh, gosh. I mean, I always tell our patients I strongly encourage it if they bring up especially. You know, I never want to patient of mine or their family members to look back and have any regrets. And so, from the get-go, I think that they should seek opinions. They should feel comfortable with the management that I or someone else is recommending to them.
And, if a person asks me if it’s okay if they seek an opinion, I’m actually very encouraging of it because it doesn’t hurt my feelings. In fact, I think, again, it empowers the patient, which at the end of the day I think is most important and allows, hopefully, for them to have no regrets. And, I always tell patients more heads are better than one. So, if a colleague has another idea that perhaps I didn’t think of or vice versa, having that discussion and ultimately, that may allow for better patient care, which I think is all of our goals, which is actually our ultimate goal, I should say.
Non-Melanoma Skin Cancer Treatment Options
Non-Melanoma Skin Cancer Treatment Options from Patient Empowerment Network on Vimeo.
What are the treatment options for advanced non-melanoma skin cancer? Dr. Sunandana Chandra shares insight on how a treatment approach is determined, the types of non-melanoma skin cancer, and discusses factors considered when choosing therapy.
Dr. Sunandana Chandra is a medical oncologist and Associate Professor of Medicine at Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Learn more about Dr. Chandra.
Related Resources:
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A Review of Current Advanced Non-Melanoma Skin Cancer Treatment Options |
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Transcript:
Katherine:
How is advanced non-melanoma skin cancer treated?
Dr. Chandra:
So, usually, the first thing that might occur is a biopsy to see what it is that we think that we’re dealing with. A biopsy is then reviewed by a pathologist or a dermatopathologist, and then those results are then relayed back to the doctor who did the biopsy.
Oftentimes, it’s a dermatologist, a primary care doctor etc. Once we have the exact diagnosis and the exact pathology, we can then talk about, okay, is this removable? Is this excisable? In that situation, a dermatologist can do it; a Mohs surgeon who is a sub-specialized dermatologist can do it. In certain instances, they may say this is a larger spot, it’s a spot, etcetera, so they then may involve our surgeons or our surgical oncologists. Now, the vast majority of non-melanoma skin cancers are treated by surgery alone. They’re just excised or removed, and then the person is followed closely.
However, there are certainly situations when a person’s non-melanoma skin cancer, meaning a Merkel cell carcinoma, a cutaneous squamous cell carcinoma, or a basal cell carcinoma being the three most common non-melanoma skin cancers.
There are situations where those are too big to respect or to surgically remove. Potentially, it may cause too much disfigurement. Potentially a person or a patient may feel that they are just sick of surgery. They want no further surgery. In those instances, those patients are then often referred to medical oncologists. These are cancer doctors who treat the cancer with systemic or whole body cancer drugs and/or radiation oncologists who can use radiation beams to often treat the cancer.
Katherine:
Dr. Chandra, when you’re deciding on a treatment plan for a patient, what factors are taken into consideration?
Dr. Chandra:
So, usually, first and foremost, we have to get to know our patient and understand their own preferences, what their own goals of care are with respect to how they want to live their life, how aggressive or not they would like to be with respect to their cancer management, their functional status, which we technically call performance and status, their other illnesses or comorbidities that may kind of complicated cancer management.
For example, people with autoimmune diseases who are on steroids, or people who have uncontrolled diabetes, these are just two examples of a potential infinite list of a person’s comorbidities or illnesses that they may have that may complicate things. All of these are taken into consideration. And, I think at the end of the day, we as their doctor want to do what’s best for them and what makes the most sense to them and for them, but certainly, it takes a very detailed discussion with our patients, their loved ones, their family members, caregivers, as well as our multidisciplinary team members to kind of figure out what the next best steps are.
Dr. Chandra:
I think this is a time where if a person is diagnosed with a non-melanoma skin cancer, I want them to know that there are options out there, options that were not even available a decade ago, certainly, maybe even five years ago that have really revolutionized how we treat our patients with advanced non-melanoma skin cancers. And so, the sooner they reach out for help, I think the better the outcomes are. So, we are here to help those particular patients to the best of our ability.
Advanced Non-Melanoma Skin Cancer: Who Is on Your Healthcare Team?
Advanced Non-Melanoma Skin Cancer: Who Is on Your Healthcare Team? from Patient Empowerment Network on Vimeo.
What experts make up an advanced non-melanoma skin cancer care team? Dr. Sunandana Chandra shares an overview of typical team members who work together for optimal patient care.
Dr. Sunandana Chandra is a medical oncologist and Associate Professor of Medicine at Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Learn more about Dr. Chandra.
Related Resources:
Why Do Advanced Non-Melanoma Skin Cancer Patients Need a Multidisciplinary Care Team? |
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Transcript:
Katherine:
People with advanced non-melanoma skin cancer typically need a multidisciplinary team. Who all is on that team?
Dr. Chandra:
So, typically the members of a multidisciplinary team include a dermatologist, including potentially a Mohs surgeon if one is available, a surgeon or a surgical oncologist, a pathologist, specifically, a dermatopathologist, if they’re available, because they really focus on scan pathology.
A medical oncologist, a radiologist who could help us read the imaging, and a radiation oncologist who can actually use radiation to treat certain spots. Now, in addition, we can often also include our palliative and supportive oncology colleagues, especially in the settings where people may have some difficult-to-treat symptoms. They may have enough of an advanced disease where we need to start kind of talking about a person’s goals of care and what their own wishes are for their cancer management and for their life. So, these palliative and supportive oncology colleagues are very, very helpful in those situations.
Katherine:
Are there also people like social workers, nutritionists?
Dr. Chandra:
Absolutely. Absolutely.
So, you know, our social workers, our nurse navigators, our nutritionist and dietitian colleagues, our nurses, our nurse practitioners, I mean, our pharmacists, it takes such a village to help take care of our patients. And I hope a patient or a person realizes that having this village at their fingertips and at our disposal only enhances their care. It’s not meant to complicate their care. It’s not meant to add unnecessary appointments. It’s just to really deliver expert care by each of these individuals who really have a focus on a particular aspect of the delivery of care.
5 Ways to Get Rid of Skin Woes and Improve Skin Health
These summer months can be a hazard to skin health if a good routine isn’t properly established. Between regular sun exposure and intense heat, your skin can react poorly to the summer climate. Constant heat and humidity can cause your skin to appear oilier than usual if you have oily skin, and rough and patchy if you typically have dry skin. These warmer months are also a prime time to get some color on your skin, but tanning will increase your chances of sunburn, premature aging, wrinkles, clogged pores, and of course, skin cancers.
With all of these potential risks, now is the perfect time to develop a summer-specific skincare routine to protect yourself from all of the harmful effects the sun can have on your skin.
Avoid Touching Your Face
First and foremost, you should avoid touching your face, especially in the hotter summer months. Throughout the day, you touch multiple surfaces, like doorknobs, car keys, and grocery carts, all of which can contain bacteria and allergens. When touching your face or rubbing your eyes, you transfer the bacteria from your hands to your pores. This transfer can cause acne and other undesirable skin flare-ups.
Similarly, everyday accessories like eyeglasses can also spread bacteria to your face, as the frames can collect sweat on your temples, under your eyes, and on the bridge of your nose. Choosing disposable contact lenses instead of eyeglasses can help you avoid these issues altogether. If you do have to wear your frames occasionally, make sure to disinfect them properly after each use to cut down on spreading any bacteria to your face.
Regardless of the season, make sure to wash your face with a clean cloth to prevent dirt, oil, and bacteria from clogging your pores. While washing your face, you should also keep your hands and surroundings sanitary. Consider using a product, like a facial cleansing bar, to balance and nourish your skin during the summer months. The combination of a consistent cleansing schedule and a fresh pair of contacts can allow your skin and eyes to breathe, which can help tremendously on hot and dry summer days.
Keep Your Skin Hydrated
The warmer seasons pose the perfect opportunity to keep your skin moist and healthy. Having hydrated skin can significantly improve elasticity and reduce fine lines and wrinkles, especially when you’re frequently exposed to the sun. Hydrated skin can also help you combat oiliness during the summer, as dehydrated skin produces more oil to make up for lack of moisture.
Make sure you’re drinking enough water each day for both your skin and your overall health. Consider investing in a reusable water bottle to motivate you and hold yourself accountable for your daily drinking goals. It’s common for people to become dehydrated during the hotter months, and dehydration can contribute to both dry and oily skin.
Wear SPF
It’s imperative to incorporate the proper skin protection into your routine during the peak summer months. This month being UV Safety Awareness Month, reminds us to take the necessary precautions to keep our skin healthy and protected against UV rays. To do this, make sure to add SPF into your daily routine, and reapply every two hours while you’re in the sun. This will not only reduce your risk of sunburn but reduce the risk of long-term damages such as cancer.
Consider Changing Your Face Wash
When developing your summer skincare routine, you should look into the benefits of your face wash. For example, in the winter, use a nourishing face wash to avoid cold, cracked skin. In the summer, you should use a face wash to draw out the excess oil your face might produce. Double cleansing is a great way to ensure you clean out your pores fully and leave your skin feeling refreshed. You may consider washing your face 2-3 times per day to ensure your pores are clean and reduce your chances of clogging.
Exfoliate Your Skin Regularly
Exfoliation is the key to brightening and smoothing your skin and can also help remove dead skin cells, especially in the summer when there is a heightened risk of sunburn and peeling. Dead skin cells also prevent the skin from breathing properly and can lead to acne and other skin problems. Exfoliate your face and body for a smooth, healthy, and lightweight complexion; but also make sure you aren’t exfoliating too much which can cause more harm than good to your skin and its barrier.
It’s essential to reevaluate your skincare routine with the change of every season. Oftentimes, your skin will react differently depending on the weather and your interaction with the sun. Prepare and protect your skin this summer with these simple steps and be mindful of your skin health all year round!
Four Factors in Advanced Non-Melanoma Skin Cancer Treatment Decisions
How can non-melanoma skin cancer treatment be determined? In the “Advanced Non-Melanoma Skin Cancer Treatment Decisions: What’s Right for You?” program, expert Dr. Vernon Sondak from Moffitt Cancer Center shares factors that help determine non-melanoma skin cancer treatment for the best care.
1. Establish Treatment Goals
Depending on each advanced non-melanoma skin cancer patient, treatment goals may vary. Advanced non-melanoma skin cancers are often curable. With some patients, curing them may not be the primary goal – but making the patient feel better by reducing their symptoms may be the goal of their care. The end result in those cases is improved quality of life for these patients. Work together with your healthcare team to understand your treatment goals.
2. Learn About Factors That Help Determine Treatment Options
Depending on each skin cancer patient, treatment options may vary depending on the factors of patient lifestyle, overall health, other medical conditions, and patient concerns. Lifestyle factors can include things like sun exposure and sun protection after diagnosis and whether the patient is a smoker, since smoking can impact health in various ways.
3. Ask About Available Treatment Options
Advanced non-melanoma has a wide range of treatment options, which may include a combination of radiation, surgery, chemo, immunotherapy, and targeted therapy. Sometimes radiation or another treatment may be used before surgery to shrink the tumor or tumors. Or surgery may not be used at all. Make sure to ask your doctor about the treatment options and why one of the types is not part of your treatment plan to ensure you have a thorough understanding of your care plan.
4. Consider a Panel of Specialists
Advanced non-melanoma skin cancer is a cancer that is best treated by an experienced team of specialists. The ideal situation is to have a radiologist, surgeon, and oncologists who can coordinate with each other to carry out the best combination of radiation, surgery, chemo, immunotherapy, and targeted therapy. By working together, the team of specialists can work out the best treatment timing and combination for the optimal patient outcome.
It’s vital for advanced non-melanoma skin cancer patients to learn about the factors involved in treatment decisions. By expanding their knowledge, patients can help determine the best treatment plan for improved quality of life and optimal health outcomes.
