The content and amount of information given by medical oncologists when telling patients with advanced cancer what their treatment options are

Koedoot, C.G.; Oort, Frans J.; Haan, Rob J. de; Bakker, Pjm; Graeff, Alexander de; Haes, J.C.J.M. de

doi:10.1016/j.ejca.2003.10.008

Cited by 126 publications

(81 citation statements)

References 48 publications

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“…This may be related to quality of patient counseling [Koedoot et al 2004] and the differences in experience and availability of resources between the two settings.…”

Section: Discussionmentioning

confidence: 99%

Systemic therapy in stage IV pancreatic cancer: a population-based analysis using the National Cancer Data Base

et al. 2015

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Background: Pancreatic cancer accounts for approximately 7% of all cancer deaths. More than half of all pancreatic cancers are stage IV at diagnosis, where systemic chemotherapy is used with the goal of life prolongation as well as palliation. The patient characteristics and health system factors that drive the use of systemic therapy are unknown. Method: This is a retrospective study of stage IV pancreatic cancer patients (n = 140,210) diagnosed between 2000 and 2011 in the NCDB. NCDB contains approximately 70% of new cancer diagnosis from more than 1500 accredited cancer programs in the United States and Puerto Rico. Chi-squared test was used to determine any differences in characteristics of patients who did or did not receive systemic therapy. Results: Our study demonstrated that only 49.1% of stage IV pancreatic cancer patients received systemic therapy. The use of systemic therapy is significantly lower in female, African American/Hispanic, patients older than 40 years, those without insurance or with Medicare and Medicaid, higher Charlson Comorbidity Score, poor economic and educational status and in nonacademic centers. Conclusions: This is the largest study to evaluate the determinants of systemic therapy use in stage IV pancreatic cancer. The use of systemic therapy was significantly lower in patients older than 40 years, lower educational status, nonprivate insurance and with higher Charlson Comorbidity Scores. In addition, the use of systemic therapy was lower with female sex, African Americans/Hispanic, and lower socio-economic status. Understanding the barriers in the use of systemic therapy as well as appropriate utilization of systemic therapy can both optimize cancer care.

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“…This may be related to quality of patient counseling [Koedoot et al 2004] and the differences in experience and availability of resources between the two settings.…”

Section: Discussionmentioning

confidence: 99%

Systemic therapy in stage IV pancreatic cancer: a population-based analysis using the National Cancer Data Base

et al. 2015

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“…An Australian study in 2001 of consultations with advanced cancer patients showed that only 27% of patients were offered a choice, and 44% were given information on an alternative course of action to anticancer therapy (Gattellari et al, 2002). In a Dutch study of advanced cancer patient care, acknowledgement of the medical oncology options of palliative chemotherapy or watchful waiting occurred in half of the consultations, with just 27% receiving extensive explanation of the watchful waiting option (Koedoot et al, 2004). These results lead us to conclude that the discrepancy between reported high comfort and actual SDM practice may be greater than that our self-reported data shows.…”

Section: Discrepancy Between Reported Comfort Levels and Usual Practisementioning

confidence: 99%

The context influences doctors' support of shared decision-making in cancer care

2007

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Most cancer patients in westernised countries now want all information about their situation, good or bad, and many wish to be involved in decision-making. The attitudes to and use of shared decision-making (SDM) by cancer doctors is not well known. Australian cancer clinicians treating breast, colorectal, gynaecological, haematological, or urological cancer were surveyed to identify their usual approach to decision-making and their comfort with different decision-making styles when discussing treatment with patients. A response rate of 59% resulted in 624 complete surveys, which explored usual practice in discussing participation in decision-making, providing information, and perception of the role patients want to play. Univariate and multivariate analyses were performed to identify predictors of use of SDM. Most cancer doctors (62.4%) reported using SDM and being most comfortable with this approach. Differences were apparent between reported high comfort with SDM and less frequent usual practice. Multivariate analysis showed that specialisation in breast or urological cancers compared to other cancers (AOR 3.02), high caseload of new patients per month (AOR 2.81) and female gender (AOR 1.87) were each independently associated with increased likelihood of use of SDM. Barriers exist to the application of SDM by doctors according to clinical situation and clinician characteristics.

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“…O ncologists frequently avoid explicit discussions of life expectancy or alternatives to chemotherapy, [1][2][3] are reluctant to discuss hospice and resuscitation preferences, 4 and make more optimistic rather than pessimistic statements in consultations. 5 Patients with advanced cancer may consequently choose to receive aggressive treatment near the end of life rather than palliative care due to overly optimistic perceptions of life expectancy or the benefit of aggressive treatment.…”

Section: Introductionmentioning

confidence: 99%

Discussions of Life Expectancy Moderate Relationships between Prognosis and Anxiety or Depression in Men with Advanced Cancer

Cripe

Rawl

Schmidt

et al. 2012

Journal of Palliative Medicine

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The content and amount of information given by medical oncologists when telling patients with advanced cancer what their treatment options are

Cited by 126 publications

References 48 publications

Systemic therapy in stage IV pancreatic cancer: a population-based analysis using the National Cancer Data Base

Systemic therapy in stage IV pancreatic cancer: a population-based analysis using the National Cancer Data Base

The context influences doctors' support of shared decision-making in cancer care

Discussions of Life Expectancy Moderate Relationships between Prognosis and Anxiety or Depression in Men with Advanced Cancer

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