Decision making and quality of life in the treatment of cancer: a review
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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.
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.
KeywordsDecision making Quality of life Patient-reported outcomes
The authors wish to acknowledge Neal J. Meropol, MD, for his input and assistance in reviewing this manuscript.
- 1.Au H, Karapetis C, Jonker D, O’Callaghan C, Kennecke H, Shapiro J (2007) Quality of life in patients with advanced colorectal cancer treated with cetuximab: results of the NCIC CTG and AGITG CO.17 trial. J Clin Oncol 25:4002 2007 ASCO Annual Meeting ProcGoogle Scholar
- 16.Eng C, Maurel J, Scheithauer W, Wong L, Lutz M, Middleton G (2007) Impact on quality of life of adding cetuximab to irinotecan in patients who have failed prior oxaliplatin-based therapy: The EPIC trial. J Clin Oncol 25:4003 2007 ASCO Annual Meeting ProcGoogle Scholar
- 21.Goldberg RM, Tabah-Fisch I, Bleiberg H, de Gramont A, Tournigand C, Andre T et al (2006) Pooled analysis of safety and efficacy of oxaliplatin plus fluorouracil/leucovorin administered bimonthly in elderly patients with colorectal cancer. J Clin Oncol 24:4085–4091 doi: 10.1200/JCO.2006.06.9039 PubMedCrossRefGoogle Scholar
- 24.Grossman M (1972) On the concept of health capital and the demand for health. J Pol Econ 80:168–199Google Scholar
- 35.Love N, Bylund C, Meropol NJ, Marshall JL, Curley SA, Ellis LM (2007) How well do we communicate with patients concerning adjuvant systemic therapy? A survey of 150 colorectal cancer survivors. J Clin Oncol 25:4020 2007 ASCO Annual Meeting Proc Part IGoogle Scholar
- 44.National Cancer Institute Surveillance Epidemiology and End Results (SEER) Program (2004) Median age of cancer patients at diagnosis, 2000–2004 by primary cancer site, race and sex. National Cancer InstituteGoogle Scholar
- 45.O’Connor AM, Boyd NF, Warde P, Stolbach L, Till JE (1987) Eliciting preferences for alternative drug therapies in oncology: influence of treatment outcome description, elicitation technique and treatment experience on preferences. J Chronic Dis 40:811–818 doi: 10.1016/0021-9681(87)90133-0 PubMedCrossRefGoogle Scholar