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

New research suggests that many patients with advanced cancer receive treatment focused on longevity rather than comfort, even when their preference is the opposite. The study has been published in Cancer.

The treatment of severe illnesses typically aims to enhance both longevity and quality of life. However, in some cases, these objectives may conflict. Therefore, it is crucial for healthcare providers to understand each patient’s goals to ensure they receive appropriate care aligned with their wishes.

Lead author, Dr. Manan P. Shah from the University of California, Los Angeles, stated, “In advanced cancer treatment, the aim is to help patients live as long and as well as possible. However, there are instances where the goals of prolonging life and maintaining comfort may clash, leading to difficult decisions for patients and oncologists.”

To investigate the correlation between patients’ preferences and their treatment, Dr. Shah and his team analyzed survey responses from adults with advanced cancer and other serious illnesses participating in a multi-site trial on advance care planning.

Among the 1,099 patients in the study, 49% of the 231 advanced cancer patients preferred comfort-focused care, with 16% of them passing away within two years. Similar proportions were observed in the 868 patients with other serious illnesses (48% and 13%). Patients with cancer who preferred comfort-focused care were more likely than those with other illnesses to receive conflicting life-extending treatments (37% versus 19%).

Interestingly, life-extending care did not seem to extend the lives of patients who did not desire it. Among advanced cancer patients preferring comfort-focused care, there was no significant difference in two-year mortality between those who received conflicting life-extending care and those who received concordant comfort-focused care.

Dr. Shah highlighted the importance of addressing the discrepancy between patients’ desires and the care they receive. He emphasized the need for open communication between doctors and patients to align treatment with patients’ goals and resolve any discrepancies.