Oncologists’ decisions about administering late chemotherapy: What makes it so difficult?
Background: An estimated 20-50% of incurable cancer patients receive chemotherapy in the last 30 days of life, although little data support this practice. Few studies have explored oncologists’ rationales for administering late chemotherapy. This study examines factors that oncologists report influence those decisions.
Methods: In-depth individual interviews were conducted with 17 oncologists. Interviews were audio-recorded and transcribed. Transcripts were coded and content analyzed.
Results: 1) Clinical factors drive oncologists’ decisions when they point to clear treatment choices, along with patient preferences. 2) Late chemotherapy is patient-driven, and used to palliate physical and emotional symptoms, even when physical benefit is not expected. 3) Caring for dying patients is difficult and impacts oncologists and their treatment decisions.
Conclusions: Findings begin to explain why it can be so difficult for oncologists to refuse patients late chemotherapy. Doing so adds to the existing burden of caring for dying patients. At times, oncologists prescribe chemotherapy to simply help everyone feel better, regardless of expected clinical benefits or costs. Future work is needed on the impact of caring for dying patients on oncologists and on supportive interventions that promote optimal treatment decisions.
Join us for Minnie Bluhm’s lecture on Wednesday, October 28, 2015 from noon till 1 pm in person or online.
Minnie Bluhm, PhD, MPH, is an Assistant Professor in the School of Health Sciences at Eastern Michigan University. Dr. Bluhm received her PhD and MPH degrees from University of Michigan School of Public Health; she also received her bachelor’s degree from University of Michigan. Prior to joining the School of Health Sciences faculty at Eastern Michigan, Dr. Bluhm was a faculty member in the Department of Health Sciences and Administration and Head of the Gerontology Program at University of Michigan-Flint. She has served in administrative roles at the University of Michigan Health System in both clinical and research settings. Her research and teaching interests focus on patient and provider experiences of life-limiting chronic illness and qualitative research methods in health care research.
In person: This lecture will take place in E4 Fee Hall on MSU’s East Lansing campus. Feel free to bring your lunch! Beverages and light snacks will be provided.
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