Cancer Care Misalignment: Patient Goals Not Met
- Nearly 4 in 10 patients with advanced cancer who preferred comfort-focused care reported receiving treatment that prioritized extending life instead, according to a study published in Cancer1.
- The cross-sectional analysis of 1099 patients found this discordance was substantially higher among individuals with advanced cancer (37%) compared with those with other serious illnesses (19%).
- Two-year mortality was 24% for patients with advanced cancer who reported receiving life-extending care against their wishes for comfort, compared with 15% among those who felt their care...
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Patients with Advanced Cancer often Recieve Life-Extending Treatment Despite Preferring Comfort Care
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Nearly 4 in 10 patients with advanced cancer who preferred comfort-focused care reported receiving treatment that prioritized extending life instead, according to a study published in Cancer1.
The cross-sectional analysis of 1099 patients found this discordance was substantially higher among individuals with advanced cancer (37%) compared with those with other serious illnesses (19%). importantly, receiving life-extending care did not appear to improve survival in patients who expressed a preference for comfort.
Two-year mortality was 24% for patients with advanced cancer who reported receiving life-extending care against their wishes for comfort, compared with 15% among those who felt their care was aligned with comfort-focused goals. This difference was not statistically significant.
A Disconnect in Oncology Care
49% of patients with advanced cancer and 48% of patients with other serious illnesses preferred comfort-focused care, while about one-quarter in both groups preferred life-extending care. Despite these similarities, more than half (51%) of patients with advanced cancer perceived their treatment as life-extending, compared with 35% of those with other advanced illnesses.
“When treating advanced cancer, the goal is to help patients live as long and as well as possible,” Manan P. Shah, MD, medical oncologist at UCLA Health and lead author of the study, said in a statement2. “But sometimes, patients and oncologists face tough choices, especially when the goals of living longer and staying comfortable begin to compete with one another.”
Patients with advanced cancer where also younger on average than those with other illnesses (62 years vs 71 years) and reported slightly better baseline physical and mental health1. The authors noted these factors may influence oncologists to pursue more aggressive treatments, potentially exacerbating the gap between patient goals and perceived care.
Understanding the Implications
this study underscores a critical challenge in modern oncology: balancing the desire for extended life with the importance of quality of life. While advancements in cancer treatment offer the potential for longer survival, they often come with significant side effects that can diminish a patient’s well-being. the findings suggest that oncologists may be overestimating patients’ desire for