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Parental status influenced cancer care decisions
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Patients with advanced cancer who were parents often based their decisions about aggressive cancer treatment and hospice care on the fact they had dependent children, according to results of a pilot study presented at the ASCO Quality Care Symposium.
“Previous studies have established that among people with advanced cancer, parents vs. nonparents are more likely to prefer aggressive treatment vs. treatment focused on comfort and alleviation of symptoms,” researcher Devon Check, a PhD student at the University of Carolina in Chapel Hill, said during a press conference. “We wanted to learn more about why that is, and also whether having children influences parents’ treatment preferences in other ways besides serving as a motivator for life-extending treatment.”
Check and colleagues interviewed 42 patients with metastatic cancer who had children aged younger than 18 years. The median age of patients was 44 years, and the median age of their children was 12 years.
A majority of the patients (64%) stated they would pursue more aggressive, life-extending treatments, and many attributed this decision to their desire to spend more time with their children. Fifteen percent of patients stated persevering their parental function was a treatment priority, and 12% required receiving treatment close to home.
Patient decisions regarding home- or institution-based hospice and palliative care also were reflective of parental status, Check said.
Fifty-two percent of patients were interested in using hospice services in part due to the resources provided to their families during this time. Patients also expressed a desire to have institutional hospice care in order to protect their children from their dying experiences.
Researchers noted 59% of patients were interested in receiving palliative care concurrently with their cancer treatment. However, many patients associated palliative care with end-of-life care, Check said.
“Numerous psychosocial factors influence patients’ decision about cancer treatment,” Check said in a press release. “It’s important for patients with dependent children to discuss their treatment priorities with their oncologists, who may not know, for example, how important it is for a patient with children to preserve their functioning at home. We hope that our study can help oncologists engage patients with children in shared decision making and promote alignment of the treatment plan with the patients’ priorities, including family responsibilities.”
For more information:
Check D. Abstract #65. Scheduled for presentation at: ASCO Quality Care Symposium; Oct. 17-18, 2014; Boston.
Disclosure: One researcher reports a consulting/advisory role with RTI Health Solutions.
Perspective
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Gregory Masters, MD
This abstract emphasizes the need to individualize our approach for patients with unique circumstances, such as these patients with young children who may need more support with some of these difficult decisions. It is critical to understand this population and their needs. Certainly, in the future, it would be great to see more studies comparing these needs to those of other different populations, and trying to incorporate palliative care, which we know is so important for patients with advanced stages of cancer.
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