Credit: Vera Kratochvil
BOSTON—Having dependent children may motivate advanced cancer patients to pursue more aggressive treatment, a pilot study indicates.
Parental status was an important factor in treatment decision-making for most of the 42 patients studied.
A majority of patients said being a parent motivated them to pursue life-extending treatments, although some patients mentioned the importance of staying close to their families to receive treatment and retaining the ability to function as a parent.
This research was released in a presscast in advance of ASCO’s 2014 Quality Care Symposium, which is scheduled to take place October 17-18 at the Boston Marriott Copley Place. The research is set to be presented as abstract 65.*
Researchers interviewed 42 patients with metastatic cancer who have children younger than 18 years of age. The patients had an average age of 44.
When asked how having children influenced their treatment decisions, 64% of patients said being a parent motivated them to pursue life-extending treatments, largely out of a desire to have more time with their children. However, 24% of patients said being a parent did not influence their treatment decisions.
Twenty-four percent of respondents identified preserving parental functioning as a treatment priority. They didn’t want side effects interfering with their or their children’s daily lives.
And 12% of patients mentioned the importance of receiving treatment close to their families, rather than traveling for a second opinion or pursuing treatment that might require long hospital stays.
Fifty-two percent of patients indicated an interest in using hospice services. Others were specifically interested in institutional rather than home hospice care, due to a desire to protect their children from the dying experience.
Fifty-nine percent of patients reported an interest in receiving palliative care concurrent with their cancer treatment, although several patients seemed to conflate palliative care with end-of-life care.
“Numerous psychosocial factors influence patients’ decisions about cancer treatment,” said lead study author Devon Check, a PhD student at the University of North Carolina at Chapel Hill.
“It’s important for patients with dependent children to discuss their treatment priorities with their oncologist, who may not know, for example, how important it is for a patient with children to preserve their functioning at home.”
“We hope that our study can help oncologists engage patients with children in shared decision-making and promote alignment of the treatment plan with the patients’ priorities, including family responsibilities.”
Although this study included patients with a range of physical functioning and a variety of cancer types, the findings may not generalize to other patient groups.
The researchers are planning a larger study to explore the associations between parental status, parenting concerns, and decision-making about treatment for advanced cancer.
*Some of the data presented differ from data in the abstract.