What determines the timing of discussions on forgoing anticancer treatment? A national survey of medical oncologists

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
Masanori MoriTatsuya Morita

Abstract

End-of-life discussions (EOLd) including the option of forgoing anticancer treatment infrequently occur until treatment options have been exhausted for advanced cancer patients. We aimed to identify oncologist-related factors contributing to the timing of discussing the option of forgoing anticancer treatment. In this nationwide survey of 864 medical oncologists, we asked about physicians' attitudes toward the timing of discussing the option of forgoing anticancer treatment for a simulated patient with newly diagnosed metastatic cancer, physicians' experience of EOLd, perceptions of a good death, and beliefs. Multivariate analyses identified determinants of early discussions. Among 490 physicians (response rate = 57%), 167 (35%) would discuss the option of forgoing anticancer treatment "now (at the diagnosis)." Physicians' attitudes toward discussing the option "now" were significantly correlated with a greater physician-perceived importance of life completion (odds ratio (OR) = 1.30, 95%CI = 1.00-1.69, p = 0.048) and dying in a preferred place (OR = 1.29, 95%CI = 1.01-1.65, p = 0.045) for a good death, and not perceiving EOLd as being severely distressing for patients/families (OR = 0.70, 95%CI = 0.54-0.95, p = 0.021). In mult...Continue Reading

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Citations

Aug 8, 2020·Japanese Journal of Clinical Oncology·Shao-Yi ChengRaymond Ng
Aug 25, 2021·The American Journal of Hospice & Palliative Care·Ahmed Abdel-HafeezSamy A Alsirafy
Aug 31, 2021·Journal of Hospice and Palliative Nursing : JHPN : the Official Journal of the Hospice and Palliative Nurses Association·Yoko Minamiguchi, Kumi Suzuki

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