Are patients with advanced cancer receiving treatment aligned with their goals?

Among 1,099 patients in the study, 49% of the 231 patients with advanced cancer preferred comfort-focused care, and 16% of the 231 patients died within 2 years. These proportions were similar to those observed in the 868 patients with other serious illnesses (48% and 13%). Among patients preferring comfort-focused care, patients with cancer were more likely than patients with other illnesses to report receiving discordant life-extending care (37% versus 19%).

Also, life-extending care did not appear to actually extend life in patients who did not wish to receive it. Among patients with cancer preferring comfort-focused care, there was no significant difference in 2-year mortality between those who reported receiving discordant life-extending versus concordant comfort-focused care.

“This disconnect between what patients want and what they feel they’re getting is an important issue,” Dr. Shah said. “One takeaway is that doctors need to have open conversations with patients about their goals, clearly explain the intent of the treatment they are providing, and try to reconcile any real or perceived discordance between goals and treatment.” 

Reference:

Manan P. Shah , Neil S. Wenger, John Glaspy, Ron D. Hays, Rebecca L. Sudore , Maryam Rahimi MD, Lisa Gibbs, Patient-reported discordance between care goals and treatment intent in advanced cancer, Cancer, https://doi.org/10.1002/cncr.35976.