Use of chemotherapy at end of life in oncology patients

Kao, Steven; Shafiq, Jesmin; Vardy, Janette; Adams, Diana

doi:10.1093/annonc/mdp027

Cited by 146 publications

(160 citation statements)

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“…The narratives on patients' hope resemble findings of earlier research on patients' hope in treatment decision-making and many patients' strong desire for treatment in the last phase of life [14,15]. In combination with the findings on physicians' reluctance to make decisions about treatment limitation in advanced cancer [16], it comes as little surprise that patients receive chemotherapy or other cancer treatment up to weeks or even days before death [17,18]. Moreover, the narratives on patients' hope, at least in part, may explain the results of more recent quantitative research according to which patients with incurable cancer often overestimate the possible benefit of palliative chemotherapy [19].…”

Section: Trust and Information In Treatment Decision-making About Panmentioning

confidence: 52%

‘One also needs a bit of trust in the doctor … ’: a qualitative interview study with pancreatic cancer patients about their perceptions and views on information and treatment decision-making

et al. 2013

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Background: Information about diagnosis, treatment options and prognosis has been emphasized as a key to empower cancer patients to make treatment decisions reflecting their values. However, surveys indicate that patients' preferences regarding information and treatment decision-making differ. In this qualitative interview study, we explored pancreatic cancer patients' perceptions and preferences on information and treatment decision-making.Patients and methods: Qualitative in-depth interviews with patients with pancreatic cancer. Purposive sampling and qualitative analysis were carried out.Results: We identified two stages of information and treatment decision-making. Patients initially emphasize trust in their physician and indicate rather limited interest in details about surgical and medical treatment. In the latter stage of disease, patients perceive themselves more active regarding information seeking and treatment decision-making. All patients discuss their poor prognosis. Reflecting on their own situation, all patients interviewed pointed out that hope was an important driver to undergo further treatment also in advanced stages of the disease. Interviewees unanimously emphasized the difficulty of anticipating the time at which stopping cancer treatment would be the right decision. Conclusions:The findings can serve as starting point for reflection on professional decision-making in pancreatic cancer and larger representative surveys on ethical issues in treatment decision-making in pancreatic cancer.

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Section: Trust and Information In Treatment Decision-making About Panmentioning

confidence: 52%

‘One also needs a bit of trust in the doctor … ’: a qualitative interview study with pancreatic cancer patients about their perceptions and views on information and treatment decision-making

et al. 2013

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“…Treatment near end-of-life is a major subject of debate in the oncological literature [15][16][17]. Is it a sign of poor quality of care?…”

Section: Discussionmentioning

confidence: 99%

Survival prediction and frequency of anticancer treatment in cancer patients hospitalized due to acute conditions. Role of clinical parameters and PaP score

Numico

Occelli

Russi

et al. 2011

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“…Furthermore, patients' age, available resources, and local practice patterns have been shown to be associated with decisions about the provision or limitation of cancer treatment at the end of life [4,6]. With regard to cancer treatment at the end of life, quantitative research shows that the clinician is 1 predictor regarding decisions about the continuation or limitation of cancer treatment [7,8]. Qualitative interviews with oncologists as well as observational research indicate that the options considered in absence of the patients differ from the range of options discussed with the patients [9,10].…”

Section: Values and Value In Healthcarementioning

confidence: 99%

Value and Values in Cancer Care. Assessing the Benefit of Treatment in Patients with Advanced Cancer

Schildmann¹

2019

Oncol Res Treat

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In recent years, the term “value-based healthcare” has been increasingly used in debates about costs and outcomes of health interventions in cancer care. This paper distinguishes 2 meanings of the term “value” and explores the relevance of both meanings of the word for assessing the “value” of cancer drugs. At the focus of the analysis are value judgments which form an integral part of the assessment of benefit of cancer drugs. The review concludes with a reflection on individual competences and systemic factors which are relevant to decision making about the value of treatment in situations of non-curative cancer.

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Use of chemotherapy at end of life in oncology patients

Abstract: Younger age, tumour type and chemosensitivity are important predictors of patients receiving palliative chemotherapy. Individual clinician was the only predictor for continuing chemotherapy in the last 4 weeks of life.

Cited by 146 publications

References 12 publications

‘One also needs a bit of trust in the doctor … ’: a qualitative interview study with pancreatic cancer patients about their perceptions and views on information and treatment decision-making

‘One also needs a bit of trust in the doctor … ’: a qualitative interview study with pancreatic cancer patients about their perceptions and views on information and treatment decision-making

Survival prediction and frequency of anticancer treatment in cancer patients hospitalized due to acute conditions. Role of clinical parameters and PaP score

Value and Values in Cancer Care. Assessing the Benefit of Treatment in Patients with Advanced Cancer

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