Dataset Information

Patients' Hopes for Advanced Cancer Treatment.

ABSTRACT: CONTEXT:Little is known about the hopes patients with advanced (incurable) cancer have for their treatment. OBJECTIVES:The objective of this study was to describe the treatment hopes of advanced cancer patients, factors associated with expressing specific hopes, and the persons with whom hopes are discussed. METHODS:We surveyed 265 advanced cancer patients in the U.S. about their hopes for treatment at the baseline and after three months. We developed a taxonomy of hopes for treatment, which two investigators used to independently code patient responses. We explored associations between hopes for cure and patient covariates. RESULTS:We developed eight categories of hopes. We were able to apply these codes reliably, and 95% of the patient's responses fit at least one hope category. The hope categories in order of descending baseline prevalence were as follows: quality of life, life extension, tumor stabilization, remission, milestone, unqualified cure, control not otherwise specified, and cure tempered by realism. Most patients reported discussing hopes with partners, family/friends, and oncologists; a minority reported discussing hopes with nurses, primary care physicians, clergy, or support groups. In logistic regression analysis, unqualified hopes for cure were more likely in younger patients and in those who did not endorse discussing their hopes with primary care physicians. CONCLUSION:Advanced cancer patients harbor a range of treatment hopes. These hopes often are not discussed with key members of the health care team. Younger age and lack of discussion of hopes with primary care physicians may lead to less realistic hopes for cure.

SUBMITTER: DeMartini J

PROVIDER: S-EPMC6310622 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Patients' Hopes for Advanced Cancer Treatment.

DeMartini Jeremy J Fenton Joshua J JJ Epstein Ronald R Duberstein Paul P Cipri Camille C Tancredi Daniel D Xing Guibo G Kaesberg Paul P Kravitz Richard L RL

Journal of pain and symptom management 20180925 1

<h4>Context</h4>Little is known about the hopes patients with advanced (incurable) cancer have for their treatment.<h4>Objectives</h4>The objective of this study was to describe the treatment hopes of advanced cancer patients, factors associated with expressing specific hopes, and the persons with whom hopes are discussed.<h4>Methods</h4>We surveyed 265 advanced cancer patients in the U.S. about their hopes for treatment at the baseline and after three months. We developed a taxonomy of hopes fo ...[more]

PMID: 30261227

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Project description:ImportanceRecent data suggest that local treatment with radical prostatectomy or radiation may improve survival outcomes in men with advanced prostate cancer. However, evidence is lacking on treatment-related adverse effects among men with advanced prostate cancer.ObjectiveTo assess the association of local treatment on treatment-related adverse effects among men diagnosed with advanced prostate cancer.Design, setting, and participantsThis cohort study assessed men diagnosed with advanced prostate cancer (defined as T4, N1, and/or M1 prostate cancer) between January 1, 1999, and December 31, 2013, with follow-up through December 31, 2021, who were treated at Veterans Health Administration medical centers.ExposureLocal treatment with radical prostatectomy or radiation.Main outcomes and measuresMain outcomes were treatment-related adverse effects, including constitutional, gastrointestinal, pain, sexual function, and urinary function conditions, at 3 intervals after initial treatment (≤1 year, >1 to ≤2 years, and >2 to ≤5 years) after initial treatment.ResultsThis cohort study consisted of 5502 men (mean [SD] age, 68.7 [10.3] years) diagnosed with advanced prostate cancer. Of the cohort, 1705 men (31.0%) received local treatment. There was a high prevalence of adverse conditions in men receiving both local and nonlocal treatment, and these adverse conditions persisted for more than 2 years to 5 years or less after initial treatment. A total of 916 men (75.2%) with initial local treatment and 897 men (67.1%) with initial nonlocal treatment reported the presence of at least 1 adverse condition for more than 2 years to 5 years or less after initial treatment. In the first year, local treatment (vs nonlocal) was associated with adverse gastrointestinal (multivariable-adjusted odds ratio [AOR], 4.08; 95% CI, 3.06-5.45), pain (AOR, 1.57; 95% CI, 1.35-1.83), sexual (AOR, 2.96; 95% CI, 2.42-3.62), and urinary (AOR, 2.25; 95% CI, 1.90-2.66) conditions. Local treatment (without secondary treatment) remained significantly associated with adverse gastrointestinal (AOR, 2.39; 95% CI, 1.52-3.77), sexual (AOR, 3.36; 95% CI, 2.56-4.41), and urinary (AOR, 1.39; 95% CI, 1.09-1.78) conditions at more than 2 years to 5 years or less after treatment.Conclusions and relevanceIn this cohort study of men with advanced prostate cancer, local treatment was associated with persistent treatment-related adverse effects across multiple domains. These results suggest that patients and clinicians should consider the adverse effects of local treatment when making treatment decisions in the setting of advanced prostate cancer.

Dataset Information

Patients' Hopes for Advanced Cancer Treatment.

Publications

Patients' Hopes for Advanced Cancer Treatment.

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