Life and treatment goals of patients with advanced, incurable cancer

Kevin L. Rand, Daniella A. Banno, Amanda M. Shea, Larry Cripe

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose: Goals of care conversations have been suggested as a strategy for helping patients with advanced cancer manage the uncertainty and distress associated with end-of-life care. However, knowledge deficits about patient goals limit the utility of such conversations. We described the life and treatment goals of patients with incurable cancers, including goal values and expectancies. We examined the associations between paramount goals and patient prognosis, performance status, and psychological adjustment. Methods: Patients with advanced lung cancer, gastrointestinal cancer, or melanoma (N = 84) completed measures of prognosis for 12-month survival, hope, optimism, depression, and anxiety. Oncologists provided patient performance status and prognosis for 12-month survival. We conducted interviews with a subset of patients (N = 63), eliciting life and treatment goals, values, and expectancies. Results: Patient life goals resembled goals among healthy populations; whereas, treatment goals were perceived as separate and more important. Cure and fight cancer emerged as the most important goals. Patients who valued cure the most had worse performance status (M = 1.46 vs. 0.78) and more depressive symptoms (M = 6.30 vs. 3.50). Patients who valued fight cancer the most had worse self-prognosis (M = 69.23 % vs. 86.11 %), fewer treatment goals (M = 2.08 vs. 3.16), and lower optimism (M = 15.00 vs. 18.32). Conclusions: Patients with advanced cancer perceive treatment goals as separate from and more important than life goals. They hold optimistic expectancies for achieving their goals and for survival. Valuing cure highly may put patients at risk for experiencing psychological maladjustment.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalSupportive Care in Cancer
DOIs
StateAccepted/In press - Feb 11 2016

Fingerprint

Neoplasms
Therapeutics
Survival
Hope
Patient Care Planning
Depression
Gastrointestinal Neoplasms
Terminal Care
Uncertainty
Melanoma
Lung Neoplasms
Anxiety
Interviews
Psychology
Population
Optimism

Keywords

  • Advanced cancer
  • End-of-life care
  • Life goals
  • Self-regulation theory
  • Treatment goals

ASJC Scopus subject areas

  • Oncology

Cite this

Life and treatment goals of patients with advanced, incurable cancer. / Rand, Kevin L.; Banno, Daniella A.; Shea, Amanda M.; Cripe, Larry.

In: Supportive Care in Cancer, 11.02.2016, p. 1-10.

Research output: Contribution to journalArticle

Rand, Kevin L. ; Banno, Daniella A. ; Shea, Amanda M. ; Cripe, Larry. / Life and treatment goals of patients with advanced, incurable cancer. In: Supportive Care in Cancer. 2016 ; pp. 1-10.
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