Background and objective:
Cancer diagnosis and treatment can be a challenging experience for patients. A good doctor-patient relationship is fundamental to support them throughout the disease path. The objective of this study is to explore the perception of a group of oncologists concerning the relationship with their patients, in order to plan interventions that may promote patient engagement in San Raffaele Hospital Cancer Center.

Methods:
A focus group of five doctors was interviewed in November 2022 with a semi-structured questionnaire to analyze their perception concerning how their cancer patients face treatment process, their needs, difficulties and how the relationship with the doctor works.

Results:
Communication issues turn out to be one of the major obstacles to a therapeutic alliance: patients were described as unaware of their own disease state, while doctors struggle to make the treatment path understandable. One of the causes is the limited time doctors have to update patients about their conditions, which makes it difficult for them to provide necessary emotional support. As a result, patients no longer trust their doctor and prefer to ignore their status, withdrawing into fear and anxiety. Often even caregivers represent a barrier to communication and in the end doctors feel overburdened by the roles they are required to take. One further point to note is that medical reports are quickly sent by e-mails and SMS, preceding doctors that should be the reference figure.

Conclusions:
To promote patient engagement, it is fundamental to develop an action plan: to improve their work, doctors need support from a multidisciplinary team. A training in the humanization of care should be highly recommended, with the purpose of developing empathy and enhancing communication, while also taking into account cultural and social differences as well as the psychological characteristics of each patient.