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Decision making and quality of life in the treatment of cancer: a review

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Abstract

Introduction

Complexity in decision making for cancer treatment arises from many factors. When considering how to treat patients, physicians prioritize factors such as stage of disease, patient age, and comorbid illnesses. However, physicians must balance these priorities with the patient’s preferences, quality of life, social responsibilities, and fear of uncertainty. Although these factors are important, physicians are often unable to effectively judge their patients’ preferences. Patients are often unable to fully understand their prognoses and the treatment intent.

Discussion

These differences influence how patients and physicians make treatment-related decisions. Partially due to these differences, patients are initially more likely than their physicians to accept greater risk for lesser benefit from treatment. As time progresses and as they experience treatment, a patient’s preference changes, yet little is known about this process since few studies have examined it in a prospective longitudinal manner. We present an overview of the literature related to patient and physician decision making and quality of life in patients with advanced cancer, and we propose approaches to future decision-making models in cancer treatment.

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Acknowledgements

The authors wish to acknowledge Neal J. Meropol, MD, for his input and assistance in reviewing this manuscript.

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Authors and Affiliations

  1. Division of Medical Oncology, Department of Medicine, Duke University Medical Center, 2424 Erwin Rd, Suite G05, Hock Plaza, DUMC Box 2732, Durham, NC, 27710, USA

    S. Yousuf Zafar

  2. Center for Palliative Care, Duke University Medical Center, Hock Plaza, 2424 Erwin Road, Suite 1105, P.O. Box 2720, Durham, NC, 27705-3860, USA

    Stewart C. Alexander

  3. Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Duke University Medical Center, P.O. Box 17969, Durham, NC, 27715, USA

    Kevin P. Weinfurt & Kevin A. Schulman

  4. Division of Medical Oncology, Department of Medicine, Duke University Medical Center, 25165 Morris Building, P.O. Box 3436, Durham, NC, 27710, USA

    Amy P. Abernethy

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Correspondence to S. Yousuf Zafar.

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Zafar, S.Y., Alexander, S.C., Weinfurt, K.P. et al. Decision making and quality of life in the treatment of cancer: a review. Support Care Cancer 17, 117–127 (2009). https://doi.org/10.1007/s00520-008-0505-2

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  • DOI: https://doi.org/10.1007/s00520-008-0505-2

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