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Cancer Patients Often Not Involved in Treatment Decisions

Fewer than half of terminally ill patients participate in the treatment decision-making process

FRIDAY, March 27 (HealthDay News) -- In patients with incurable cancer, fewer than half are involved in the decision-making process concerning the limitation of life-prolonging treatment, according to a study published online ahead of print March 23 in the Journal of Clinical Oncology.

Eva C. Winkler, M.D., of Ludwig-Maximilians University in Munich, Germany, and colleagues studied 76 patients with incurable cancer who participated in discussions about the limitation of life-prolonging treatment.

Although the vast majority of patients were informed about their diagnosis, therapy and course of disease, the researchers found that only 47 percent of them were involved in the decision-making process for life-prolonging treatment. Palliative care was the preference of two-thirds of patients, while extending lifetime was the preference of one-third. Patients who preferred palliative care were more likely to agree with their physicians' treatment goals (91.4 percent versus 46.7 percent) and to participate in the decision-making process.

"Surprisingly, the main predictor of patient involvement was not their medical condition, but agreement with physicians' palliative treatment goals. These results show that if physicians switch to comfort care in terminally ill patients and patients are not yet prepared to follow this line, treatment limitations are often decided without involving the patient," the authors conclude.

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