Importance of avoiding late cancer-directed therapy in terminally ill cancer patients

Jahn-Kuch, Daniela

doi:10.1007/s12254-019-00564-1

memo

2020

DOI: 10.1007/s12254-019-00564-1

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Importance of avoiding late cancer-directed therapy in terminally ill cancer patients

Daniela Jahn-Kuch

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2024

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Cited by 2 publications

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“…Jahn-Kuch [1] gives an overview on how to avoid late cancer-directed therapy in terminally ill cancer patients. This remains challenging, as survival rates have improved in recent decades while treatment of cancer patients near death is becoming increasingly aggressive [2].…”

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confidence: 99%

End-of-life therapy: palliative care instead of palliative scare

Masel

2020

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confidence: 99%

End-of-life therapy: palliative care instead of palliative scare

Masel

2020

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Patients’ psychosocial attributes and aggressiveness of cancer treatments near the end of life

Restivo,

Rochigneux,

Bouhnik

et al. 2024

The Oncologist

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Background While the use of chemotherapy near the end of life (EOL) has been identified as a relevant criterion for assessing quality of cancer care and has been estimated as non-beneficial, a trend of aggressiveness in cancer care during the last period of life remains. Both patients’ sociodemographic characteristics and physicians’ practice setting are associated with this use. The role of patients’ psychosocial characteristics has however been understudied. The objectives were to study oncologists’ intention to recommend chemotherapy or therapeutic abstention in an EOL patient’s case and to examine the factors associated with this decision. Methods A clinical vignette-based questionnaire survey was conducted. While the case presented to the participating oncologists of a patient with EGFR-mutated lung cancer, progressing after osimertinib, ECOG 3, with leptomeningeal disease (N = 146), was strictly equivalent in terms of medical aspects and age, 4 patients’ non-medical characteristics were manipulated: gender, marital status, parenthood, and psychosocial characteristics (“nice” patients, patients “making strong demands,” or control patients). Results 77.4% of the oncologists surveyed stated that they would recommend chemotherapy in this situation. Only scenarios with nice patients or patients making strong demands were associated with less recommendation of chemotherapy (70.8% for the nice/making strong demands scenarios together vs 87.7%, for the control scenario P = .017). Medical oncologists with previous experience of similar cases were also less keen to recommend chemotherapy (73% vs 100%, P = .007). Of the 76.7% of respondents declaring that they would think of other therapeutic options, 49.1% mentioned “other treatments” without mentioning palliative care. Conclusion Developing physicians’ awareness of the psychosocial aspects at stake in their medical decisions in these sensitive situations may improve EOL care.

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Importance of avoiding late cancer-directed therapy in terminally ill cancer patients

Cited by 2 publications

References 25 publications

End-of-life therapy: palliative care instead of palliative scare

End-of-life therapy: palliative care instead of palliative scare

Patients’ psychosocial attributes and aggressiveness of cancer treatments near the end of life

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