Decisions for lung cancer chemotherapy: the influence of physician and patient factors
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The purpose of this study is to review the literature examining how the beliefs and behaviours of physicians and patients influence clinical communication, doctor–patient interaction and treatment decisions for lung cancer treatment.
Literature was obtained via electronic database searches and hand searching of journals from 1990 to 2011.
Wide variability in perceptions of the value of chemotherapy in lung cancer is present among both physicians and patients. There is a mismatch in the degree patients and physicians weigh survival, such that patients value survival benefits highly whilst physicians strongly emphasize toxicity and associated symptoms. This lack of congruence between patients and clinicians is influenced by a range of factors and has implications for treatment decisions, long-term survival and quality of life in people affected by lung cancer.
The divergence of treatment priorities indicates a need for improved communication strategies addressing the needs and concerns of both patients and clinicians. Patients should understand the benefits and risks of treatment options, while clinicians can gain a greater awareness of factors influencing patients’ decisions on treatments. Reflecting these perspectives and patient preferences for lung cancer treatment in clinical guidelines may improve clinician awareness.
KeywordsLung cancer Chemotherapy Decision-making Patient preference
This paper is part of a larger project titled Lung Cancer in Australia: Review of the Evidence, Consultation & Research. This project received funding from the Australian Government through Cancer Australia. Dr. DiGiacomo is a postdoctoral fellow supported by NHMRC 533547.
Conflict of interest
The authors have no conflicts of interest to declare other than funding received from Cancer Australia.
- 5.Chu DT, Kim SW, Kuo HP, Ozacar R, Salajka F, Krishnamurthy S, Damyanov D, Altug S, Reece WHH, Wang L (2007) Patient attitudes towards chemotherapy as assessed by patient versus physician: a prospective observational study in advanced non-small cell lung cancer. Lung Cancer 56:433–443PubMedCrossRefGoogle Scholar
- 6.Clayton JM, Hancock KM, Butow PN, Tattersall M, Currow DC (2007) Clinical practice guidelines for communicating prognosis and end-of-life issues with adults in the advanced stages of a life-limiting illness, and their caregivers. Med J Aust 186:S83–S108Google Scholar
- 11.Efficace F, Bottomley A, Smit EF, Lianes P, Legrand C, Debruyne C, Schramel F, Smit HJ, Gaafar R, Biesma B, Manegold C, Coens C, Giaccone G, Van Meerbeeck J (2006) Is a patient’s self-reported health-related quality of life a prognostic factor for survival in non-small-cell lung cancer patients? A multivariate analysis of prognostic factors of EORTC study 08975. Ann Oncol 17:1698–1704PubMedCrossRefGoogle Scholar
- 30.Silvestri G, Pritchard R, Welch HG (1998) Preferences for chemotherapy in patients with advanced non-small cell lung cancer: descriptive study based on scripted interviews. Br Med J 317:771Google Scholar