Refusal of Curative Radiation Therapy and Surgery Among Patients With Cancer

Income inequality and treatment of African American men with high-risk prostate cancer

“…Poor communication between patients and providers regarding the efficacy and adverse effects of treatment likely encourages decisional regret among some AA men [30] and contributes to the prevalence of shared perspectives for or against certain health care interventions within communities. Patient refusal of recommended surgery or radiation is correlated with increased prostate cancer mortality [31], and it is probable that disproportionately fewer recommendations for primary therapy to AA men likewise contribute to less receipt of therapy and greater prostate cancer mortality.…”

Decision Making in Lung Cancer – How Applicable are the Guidelines?

“…Sociodemographic factors have also been associated with patient acceptance of treatment. Older age, lower incomes, non-White race and non-married status were associated with refusal of both curative surgery for NSCLC and curative radiotherapy for SCLC in an analysis of SEER data, resulting in poorer cancerspecific survivals [29].…”

“…At a population level, an Australian patterns of care study has shown that 20% of patients with potentially curable cancers declined to have any treatment [22]. The figure is lower in SEER population data, where 1.5% of NSCLC patients offered curative surgery and 1.4% of SCLC patients offered curative radiotherapy refused the recommended treatment [29].…”

Age-based disparities in treatment and outcomes of retroperitoneal rhabdomyosarcoma

“…In one study, 7-22 % of cancer patients were judged to be good candidates for chemotherapy, were actively counseled about their disease, and were recommended for chemotherapy, yet refused it [12]. Patients refuse their physician's recommendation much more rarely regarding surgical and radiotherapy treatments for cancer (0.4 and 0.9 %, respectively), although a positive correlation does exist with increasing age [13,14]. Clearly the morbidity associated with chemotherapy carries with it a special stigma.…”