Decision consultations on preoperative radiotherapy for rectal cancer: large variation in benefits and harms that are addressed
| Autor: | Anne M. Stiggelbout, D.A.R.H. Grootenboers, Heleen M. Ceha, Tom Rozema, Corrie A.M. Marijnen, Arwen H. Pieterse, Marleen Kunneman, Karen J. Neelis |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Preoperative radiotherapy Colorectal cancer preoperative radiotherapy Treatment outcome Decision Making shared decision making Medicine Humans rectal cancer Referral and Consultation Aged Aged 80 and over Physician-Patient Relations business.industry Rectal Neoplasms communication General surgery Middle Aged medicine.disease Surgery Variation (linguistics) Treatment Outcome Oncology information provision Clinical Study Female business |
| Zdroj: | British Journal of Cancer, 112(1), 39-43 British Journal of Cancer |
| Popis: | Background:For shared decision making to be successful, patients should receive sufficient information on possible benefits and harms of treatment options. The aim of this study was to evaluate what information radiation oncologists provide during the decision consultation about preoperative radiotherapy with rectal cancer patients.Methods:Decision consultations of 17 radiation oncologists with 81 consecutive primary rectal cancer patients, eligible for short-course radiotherapy followed by a low-anterior resection, were audio taped. Tapes were transcribed and analysed using the ACEPP (Assessing Communication about Evidence and Patient Preferences) coding scheme.Results:A median of seven benefits/harms were addressed per consultation (range, 2-13). This number ranged within and between oncologists and was not clearly associated with the patient's characteristics. A total of 30 different treatment outcomes were addressed. The effect of radiotherapy on local control was addressed in all consultations, the effect on survival in 16%. The most important adverse effects are bowel and sexual dysfunction. These were addressed in 82% and 85% of consultations, respectively; the latter significantly less often in female than in male patients. Four out of five patients did not initiate discussion on any benefits/harms.Conclusions:Our results showed considerable inconsistency between and within oncologists in information provision, which could not be explained by patient characteristics. This variation indicates a lack of clarity on which benefits/harms of radiotherapy should be discussed with newly-diagnosed patients. This suboptimal patient information hampers the process of shared decision making, in which the decision is based on each individual patients' weighing of benefits and harms.British Journal of Cancer advance online publication, 21 October 2014; doi:10.1038/bjc.2014.546 www.bjcancer.com. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|