What to do when treatment prolongs life … But at the cost of comfort, or an already fragile quality of life? A new study conducted by the UCLA and published in Cancer Reveals a disturbing dissonance: many patients with advanced cancer consider receiving care that do not correspond to what they really want.
When living longer is not always the priority
Advanced cancer often confronts patients and their families with painful choices: should we favor lifespan at all costs, or on the contrary comfort, to preserve the last months or years? These discussions are essential, but they are sometimes too late or insufficient. Result: some patients find themselves engaged in heavy protocols that they had not wanted.
As Dr Manan P. Shah (UCLA), principal author of the study reminds us: “This discrepancy between what patients want and what they think to receive is an important problem. One lesson to be learned is that doctors must have open conversations with patients about their objectives, clearly explain the intention of the treatment they offer and try to resolve any discrepancy, real or perceived, between objectives and treatment “.
A study that reveals a worrying gap
To understand this discrepancy, the researchers analyzed the responses to a questionnaire filled with 1,099 patients with serious illnessesof which 231 people with advanced cancer.
The results are speaking:
- 49 % of advanced cancer patients said they preferred comfort on comfort, against 48 % in other serious patients;
- However, among these patients, 37 % of cancer patients have reported to receive care despite prolonging life, even when they did not want – against only 19 % in other patients;
- Finally, researchers note that receiving a life -prolonged treatment did not provide significant benefit in terms of survival : at two years, the mortality rate was similar between patients who received comfort care and those who had aggressive treatments against their will.
In other words: undergoing heavy treatment which was not desired does not seem to have prolonged life, but has been able to reduce the quality of recent months.
Why such a shift?
The observation is worrying, but it should not be interpreted as an individual fault: it reflects the complexity of cancer and its treatment. As Dr. Shah points out in the UCLA press release: “Even if this study is based on the perception of patients, it remains deeply problematic that patients have the feeling of receiving care that does not correspond to what they wish. This is a sign that we must improve communication and shared decision “.
The study advances several explanations:
- Cancer patients are often younger and in better health than those with other advanced diseases, which can push medical teams to offer aggressive treatments;
- The rapid progress in oncology sometimes suggests that a protocol prolongs both life And The quality of life-but the profits are not always there.
Professor Anne WALLING (UCLA), co-author, recalls that these choices require a constant dialogue: “Advances in treatments targeting cancer can often offer both greater longevity and better quality of life, even in patients with advanced cancer. However, there are sometimes compromises, and high quality communication is necessary to ensure that these complex and nuanced decisions are explained to the patient and that decision -making is centered on the objectives and values of patients “.
Give back to patients
Researchers therefore call to establish earlier and deeper discussions between doctors and patients, so that care objectives are always at the heart of the therapeutic journey. As Dr. Shah says: “Patients should always feel encouraged to express themselves. If they believe that their care is not aligned with their goals, we want to know. As doctors, we always want to adjust the treatment to grant ourselves with the wishes of our patients. These crucial conversations can change the course of care and optimize the quality of life of patients “.
A message of hope: speak, clarify, and above all listen, so that each patient can face the disease according to their own values.