Patients with advanced gastrointestinal cancer, lung cancer, and melanoma view life goals as distinct from and less important than treatment goals, a study published in the journal Supportive Care in Cancer has shown.1
Goals of care conversations should take place between clinicians and patients with advanced cancer and their caregivers to help manage uncertainty and distress at the end of life. However, there are limited data about patient goals to influence those conversations. Therefore, researchers sought to describe the treatment and life goals, including goal values and expectations, of patients with incurable cancers and evaluate associations between goals and patient prognosis, performance status, and psychological adjustment.
For the study, researchers enrolled 84 patients with advanced gastrointestinal cancer, lung cancer, or melanoma. All participants completed questionnaires about their prognosis for 1-year survival, anxiety, depression, hope, and optimism. Researchers also analyzed patient performance status and prognosis for 1-year survival provided by their oncologists and conducted interviews about goals, values, and expectations with 63 patients.
Results showed that life goals among patients were similar to those among health populations, but treatment goals were viewed as separate and more important than life goals. Researchers identified curing and fighting cancer as the most important goals reported by participants.
The study demonstrated that patients who valued cure as the most important goal had worse performance status and more depressive symptoms, while patients who valued fighting cancer the most had worse self-prognosis, fewer treatment goals, and reduced optimism.
The findings suggest that valuing cure highly may negatively impact patients with advanced cancer psychologically.
1. Rand KL, Banno DA, Shea AM, Cripe LD. Life and treatment goals of patients with advanced, incurable cancer [published online ahead of print February 11, 2016]. Supp Care Cancer. doi: 10.1007/s00520-016-3113-6.