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Supportive Care in Cancer

, Volume 17, Issue 2, pp 117–127 | Cite as

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

  • S. Yousuf ZafarEmail author
  • Stewart C. Alexander
  • Kevin P. Weinfurt
  • Kevin A. Schulman
  • Amy P. Abernethy
Review Article

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.

Keywords

Decision making Quality of life Patient-reported outcomes 

Notes

Acknowledgements

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

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • S. Yousuf Zafar
    • 1
    Email author
  • Stewart C. Alexander
    • 2
  • Kevin P. Weinfurt
    • 3
  • Kevin A. Schulman
    • 3
  • Amy P. Abernethy
    • 4
  1. 1.Division of Medical Oncology, Department of MedicineDuke University Medical CenterDurhamUSA
  2. 2.Center for Palliative CareDuke University Medical CenterDurhamUSA
  3. 3.Center for Clinical and Genetic Economics, Duke Clinical Research InstituteDuke University Medical CenterDurhamUSA
  4. 4.Division of Medical Oncology, Department of MedicineDuke University Medical CenterDurhamUSA

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