Decision making in palliative radiation therapy: reframing hope in caregivers and patients with brain metastases

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
Jacqueline SzeR Wong

Abstract

To explore the major factors important in decision making for whole-brain radiotherapy (WBRT) for patients with brain metastases and their caregivers. Two parallel qualitative studies, one for patients and one for caregivers of patients with newly diagnosed brain metastases, were conducted. Semistructured interviews were conducted and audiotaped with each participant. Content analysis and theme extraction of the transcripts were undertaken to identify recurring themes and relational patterns. Twenty patients and 19 caregivers (including eight patient and caregiver pairs) were recruited into the study. Four major factors were identified to influence decision making of whole-brain radiation: hope, knowledge, expectations of radiation therapy, and current symptoms. Analysis reveals that patients generally focus on current informational needs, while caregivers want more information about the future (e.g., life expectancy and anticipated symptoms). Caregivers expressed frustration when unable to explore future needs because patients were unprepared to discuss prognostic issues. Participants expressed substantial relief when offered WBRT after the diagnosis, but WBRT is often considered the only available plan rather than an informed...Continue Reading

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Citations

Sep 25, 2007·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Michael SanataniLarry Stitt
Aug 13, 2013·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Hellen JungJackson Sai-Yiu Wu
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Aug 7, 2019·Neuro-oncology Practice·Janet PapadakosCaroline Chung

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