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Tuesday, 19 October 2004 - 8:45 AM

This presentation is part of: Oral Concurrent Session A - Patient and Physician Behavior/Preferences 2

ATTITUDES OF PATIENTS WITH INCURABLE CANCER TOWARDS MEDICAL TREATMENT

E. Voogt, MA1, A. van der Heide, MD, PhD1, A.F. van Leeuwen, MD, PhD1, J.A.C. Rietjens, MSc1, A.P. Visser, PhD2, and P.J. van der Maas, MD, PhD1. (1) Erasmuc MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, Netherlands, (2) Helen Dowling Institute, Center for Psycho-oncology, Utrecht, Netherlands

When cancer has advanced to a stage in which cure becomes very unlikely, patients may have to consider whether they appreciate further life-prolonging treatment or not. We assessed the attitudes of cancer patients towards such treatment.

Patients who suffered from breast, lung, colorectal, prostate or ovary cancer, which had recently progressed into an incurable stage, were interviewed and asked to fill out a written questionnaire about their attitudes concerning life-prolonging treatment and about end-of-life decision-making (Quality Quantity Questionnaire, Stiggelbout, 1996).

122 patients (mean age 64 yr. (sd=10.5), 53% women) participated in the study. Patient attitudes concerning trade-offs between quality of life and length of life could be categorized into three different profiles: striving for quality of life (33%), striving for length of life (38%), and no clear preference (29%). Older patient and patients who were more tired, or had less positive feelings, and patients who had discussed their wishes concerning medical treatment with their health care professionals or family members, or had filled out an advance directive were more inclined to strive for quality of life. In contrast, patients with a history of cancer of less than six months were more inclined to prefer life-prolongation than patients with a longer history of cancer.

We conclude that patients with incurable cancer vary in their attitudes concerning the application of life-prolonging treatment. These attitudes are related to patient and disease characteristics and to discussing and making decisions about end-of-life care. Being aware of these differences may help physicians in their communication with patients about end-of-life care.


See more of Oral Concurrent Session A - Patient and Physician Behavior/Preferences 2
See more of The 26th Annual Meeting of the Society for Medical Decision Making (October 17-20, 2004)