Importance of quality-of-life priorities and preferences surrounding treatment decision making in patients with cancer and oncology clinicians
Open accessAbstract
Background: Shared decision‐making (SDM) occurs when a patient partners with their oncologist to integrate personal preferences and values into treatment decisions. A key component of SDM is the elicitation of patient preferences and values, yet little is known about how and when these are elicited, communicated, prioritized, and documented within clinical encounters. Methods: This cross‐sectional study evaluated nationwide data collected by Cancer Care to better understand current patterns of SDM between patients and their oncology clinicians. Patient surveys included questions about the importance of quality‐of‐life preferences and discussions regarding quality‐of‐life priorities with their clinicians. Clinician surveys included questions about the discussion of quality‐of‐life priorities and preferences with patients, the effect of quality‐of‐life priorities on treatment recommendations, and quality‐of‐life priority documentation in practice. Results: Patient survey completers (n = 320; 33% response rate) were predominantly women (95%), had a diagnosis of breast cancer (59%), or were receiving active cancer treatment (59%). Clinician survey completers (n = 112; 5% response rate) predominately identified as hematologists or oncologists (66%). Although 67% of clinicians reported knowing their patients' personal quality‐of‐life priorities and preferences before finalizing treatment plans, only 37% of patients reported that these discussions occurred before treatment initiation. Most patients (95%) considered out‐of‐pocket expenses important during treatment planning, yet only 59% reported discussing out‐of‐pocket expenses with their clinician before finalizing treatment plans. A majority of clinicians (52%) considered clinic questionnaires as feasible to document quality‐of‐life priorities and preferences. Conclusions: Patients and clinicians reported that preferences related to quality‐of‐life should be considered in treatment decision making, yet barriers to SDM, preference elicitation, and documentation remain.
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In colorectal or lung cancer, adjuvant systemic therapy may be safely delayed by as much as 8 weeks.
“For example, for patients with colorectal or lung cancer, it can be safely postponed for up to 8 weeks [89,90], and for those with breast cancer for up to 12 weeks after surgery [91].”
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References 39 · Cited by 74
- Authors
- Williams, C. P., Miller‐Sonet, E., Nipp, R. D., Kamal, A. H., Love, S., & Rocque, G. B.
- Affiliations
- University of Alabama at Birmingham (US)
- CancerCare (US)
- Harvard University (US)
- Duke Medical Center (US)
- Dr. Susan Love Foundation for Breast Cancer Research (US)
- Corresponding author
- Williams, Courtney P.
- ORCID
- Venue
- Cancer
- Publisher
- Wiley
- Published
- 2020-05-19
- Volume
- 126
- Issue
- 15
- Pages
- 3534-3541
- ISSN
- 0008-543X (ISSN-L)
- 1097-0142
- OpenAlex
- W3027977945
- Cited by
- 74
- References
- 39
- Citations by year
- 2026: 16 · 2025: 14 · 2024: 10 · 2023: 10 · 2022: 14 · 2021: 7 · 2020: 3
- FWCI
- 8.87
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cancer (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- shared decision-making, patient preferences, treatment decision-making, preference elicitation, out-of-pocket costs, clinician-patient communication, cancer patients, oncologists
- MeSH terms
- Oncologists, Decision Making, Shared, Adult, Aged, Aged, 80 and over, Breast Neoplasms, Female, Humans, Male, Middle Aged, Neoplasms, Patient Care Planning, Patient Participation, Physician-Patient Relations, Quality of Life, Colorectal Neoplasms, Patient Preference
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