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Decisions for lung cancer chemotherapy: the influence of physician and patient factors

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Abstract

Purpose

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.

Methods

Literature was obtained via electronic database searches and hand searching of journals from 1990 to 2011.

Results

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.

Conclusion

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.

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Acknowledgments

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.

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Authors and Affiliations

  1. Centre for Cardiovascular and Chronic Care, University of Technology Sydney, PO Box 123, Broadway, NSW, 2007, Australia

    Patricia M. Davidson & Phillip J. Newton

  2. Health Innovation (Chronic Diseases), Curtin Health Innovation Research Institute (CHIRI), Curtin University, GPO Box U1987, Perth, WA, 6845, Australia

    Moyez Jiwa

  3. Centre for Cardiovascular and Chronic Care, University of Technology Sydney & Curtin University, PO Box 123, Broadway, NSW, 2007, Australia

    Alice J. Goldsmith, Sarah J. McGrath & Michelle DiGiacomo

  4. The Cunningham Centre for Palliative Care, The University of Notre Dame Australia, P.O. Box 944, Broadway, Sydney, NSW, 2007, Australia

    Jane L. Phillips

  5. SSWAHS Area Palliative Care Service (Western Zone), Braeside Hospital, Locked Bag 82, Wetherill Park, 2164, Australia

    Meera Agar

  6. Discipline of Palliative and Supportive Services, Flinders University, Adelaide, SA, 5041, Australia

    David C. Currow

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  1. Patricia M. Davidson
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  2. Moyez Jiwa
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  3. Alice J. Goldsmith
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  4. Sarah J. McGrath
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  5. Michelle DiGiacomo
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  6. Jane L. Phillips
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  7. Meera Agar
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  8. Phillip J. Newton
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Correspondence to Patricia M. Davidson.

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Davidson, P.M., Jiwa, M., Goldsmith, A.J. et al. Decisions for lung cancer chemotherapy: the influence of physician and patient factors. Support Care Cancer 19, 1261–1266 (2011). https://doi.org/10.1007/s00520-011-1176-y

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  • DOI: https://doi.org/10.1007/s00520-011-1176-y

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