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At UCSF, Patients, Doctors Share Decisions on Treatment

Dr. Jasmine Wong, a surgeon at UC San Francisco, explains treatment options to Gutierrez. A small red USB audio recorder sits between them and captures the conversation (Photo by Heidi de Marco/KHN).

Dr. Jasmine Wong, a surgeon at UC San Francisco, explains treatment options to Gutierrez. A small red USB audio recorder sits between them and captures the conversation (Photo by Heidi de Marco/KHN).

By Anna Gorman, Kaiser Health News

SAN FRANCISCO — Rose Gutierrez has a big decision to make.

Gutierrez, who was diagnosed with breast cancer last spring, had surgery and 10 weeks of chemotherapy. But the cancer is still there. Now Dr. Jasmine Wong, a surgeon at UC San Francisco, is explaining the choices – Gutierrez can either have another lumpectomy followed by radiation, or she can get a total mastectomy.

“I think both options are reasonable,” Wong said. “It’s just a matter of how you feel personally about preserving your breast, how you feel about having radiation therapy.”

Many patients aren’t accustomed to speaking up, so hospital provides tools for decisionimaking on treatments.

“I’m kind of scared about that,” said Gutierrez, 52, sitting on an exam table with her daughter on a chair beside her.

“Well if you made it through chemo, radiation is going to be a lot easier,” Wong told Gutierrez, who is from Merced, Calif.

In many hospitals and clinics around the country, oncologists and surgeons simply tell cancer patients what treatments they should have, or at least give them strong recommendations. But here, under a formal process called “shared decision making,” doctors and patients are working together to make choices about care. Continue reading

New Phone-Based Program May Help Lower Diabetes Risk

By Alvin Tran

The study relied on health educators to help participants make healthy choices. (Jerry Bunkers/Flickr)

Get active. Eat Smart. Eat your colors. And eat breakfast.

These were the four themes guiding participants in “Live Well, Be Well,” a diabetes prevention program in the San Francisco Bay Area for underserved communities.

Live Well, Be Well was also a new study led by researchers at UCSF and implemented by the City of Berkeley’s Division of Public Health. 

The researchers recruited over 230 adults at risk for diabetes from Berkeley, Oakland, and Richmond. They were randomized, and half received a series of phone-based, lifestyle counseling sessions. The other half, the control group, was offered counseling after one year. 

Participants chose from the four themes to guide their sessions, says UCSF Associate Professor of Medicine and lead author of the study, Dr. Alka Kanaya, M.D.

“We wanted to basically see which [theme participants felt] most interested in and the one they felt were most feasible for them to make a change. We really did want to pound home the message about healthy diet, eating correct portion sizes, [and] making smart choices when you’re eating food.”

Trained health educators from Berkeley’s Division of Public Health guided these phone-based sessions and helped participants create goals for diet and exercise. After six months, the counseling sessions stopped. Continue reading