At the Nixon National Cancer Conference held in January 2025, experts discussed the crisis of trust in medical authorities within the society. Despite significant advancements in treatment and care, doctors do not have enough time to establish trust with patients, turning them directly into customers through advertising.
In a study conducted by the Pew Research Center in October 2024, over 10,000 American adults were surveyed with a 90% response rate, receiving over 9,500 responses. Among them, 51% of Americans supported scientists playing an active role in public policy debates, down from 60% in 2020; and 57% believed that science has a positive impact on society, down from 73% in 2019. In 2023, the public’s trust in scientists decreased to 73%, down from 86% in 2019, showing a declining trend.
Dr. Edward S. Kim, Vice Chief Physician at City of Hope, chaired the panel discussion, with Dr. Hazem H. Chehabi, Chairman of Nuclear Medicine Physics Department at Newport Diagnostic Center in Orange County, and Dr. Sanjay Juneja, a blood and cancer expert and podcast host from Louisiana, sharing their perspectives from the doctors’ point of view.
Dr. Kim mentioned that public awareness regarding cancer and its treatment methods is still evolving, and the issue of trust between doctors and patients has existed for decades, not just limited to post-COVID times.
Dr. Juneja stated, “Trust begins with honesty, transparency, and ownership, involving potential mistakes and expectations, as well as cultural attitudes.” Doctors are under significant pressure, and the effectiveness of treatment varies for each type of cancer. From a healthcare perspective, the core concept is to involve patients, but the same diagnosis can evoke feelings of both happiness and fear, greatly linked to the psychological and emotional well-being of patients and their families.
Dr. Chehabi emphasized that patients seek information when searching for a doctor, whether from websites or technical lectures. He mentioned the importance of not belittling or judging patients’ viewpoints, spending time talking with them, inquiring about their situation, explaining clinical treatments, staging diagnoses, and assessing responses. Establishing trust begins with allocating time and conducting meetings, “nothing is taken for granted, providing patients with time to make decisions.” For patients and their families, “never be afraid to ask questions to doctors, spend time talking face-to-face, ask all the questions, share information, and get the answers you seek before making decisions, but it’s not easy.”
In the Pew Research Center survey, 78% of the public had confidence in medical professionals acting in the best interest of the public; however, only 45% thought that scientists were good communicators. Dr. Kim grew up in a small town in Indiana where people trusted their family doctor living across the street, following their advice. But now, people have more sources to obtain information.
During his tenure on the Medical Ethics Committee, Dr. Chehabi saw some doctors provide top-notch professional help, while others faced disciplinary actions. Medical ethics are crucial, but it’s challenging to change the mindset of someone in their fifties or sixties. Either doctors engage in ethical and honest communication with patients or not; this is something the medical field must strive for.
In a report released by the American Cancer Society on January 16, 2025, it was stated that from 1991 to 2022, the cancer death rate in the United States decreased by 34%, saving approximately 4.5 million lives, but facing the threat of rising cancer incidence rates. The report projected over 2 million new cancer cases in the United States in 2025 (5,600 cases per day), with 618,000 cancer-related deaths. According to the 2022 report by the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death in the United States, while cancer remains the second leading cause.
Dr. Kim mentioned that when doctors offer genuine advice, patients, family, or friends may not necessarily believe it, as experiences and pain prevent them from trusting. Faced with a patient suffering from metastatic breast cancer for at least 15 years, the doctor identified chronic pain as the primary cause of her weakness. However, when Dr. Kim suggested trying a specific pain relief method, she perceived it as a sales pitch.
Dr. Juneja highlighted that such situations are common and challenging. When administering chemotherapy to patients in phases two or three, doctors hope they do not develop a fever or require hospitalization, but chemotherapy comes with side effects like hair loss. Six months later, if the patient’s condition relapses, the trust in the doctor becomes fractured, requiring doctors to explain the scan results, which may not always be favorable.
Dr. Chehabi emphasized the principle of doing no harm, but varying degrees of side effects are inevitable, so “it is crucial to fully understand the attitude and acceptable level of patients and their families.”
Dr. Juneja mentioned the introduction of “targeted therapy” and the importance of molecular testing, revealing that 10% of people, including 15% of Latinx or Black individuals, have not undergone the necessary molecular testing for treatment. For stage IV cancer patients, he recommends molecular testing, which serves as an “educational” effort.
Doctors today not only treat patients but also manage computer documentation, bills, and insurance. Dr. Chehabi added, “But you have to find time to establish relationships and trust with patients. I review scan images with every patient who comes to me, scheduling it within my agenda; this is also a mission.”
“Artificial intelligence (AI) technology may be helpful,” Dr. Juneja stated. “We repeatedly explain the same things like the micro-disease and how tumors evolve, predicting treatment outcomes, etc.” He mentioned “prompt engineering,” which can explain within seconds why chemotherapy is needed for non-spread breast cancer, potential side effects, etc. “But is this offensive or trustful?” he said; non-medical professionals can also perform this task, but AI technology significantly reduces the workload and holds enormous potential.
Social media has become a primary source of information, with young people like his daughter obtaining a lot of information and guidance from platforms like TikTok, but Dr. Juneja highlighted that such unverified information lacks credibility. Therefore, when faced with a plethora of information contradicting traditional medicine, doctors need to verify it; moreover, there is a need for “evergreen explanations and solutions.”
Textbooks and medical conferences are also sources of information, Dr. Kim noted, stressing the difficulty of filtering information, stating that textbooks offer limited assistance to many authors. Additionally, groundbreaking research presented at national conferences is often covered by the media, but information not published in peer-reviewed journals requires practical implementation and truth-seeking efforts. ◇