Background
While physician attitudes about treatment goals have been examined around end-of-life
care, surgeon attitudes regarding communication of therapeutic goals prior to cancer-directed
operations have not been investigated. We examined how surgeons discuss the potential
for cancer “cure” prior to operative treatment and how surgeons perceive patient priorities
and treatment goals.
Methods
Surgeons were invited to complete a Web-based survey about attitudes and practices
when discussing cancer-directed operations, including how they defined cancer cure
and whether and how they discussed cure as a treatment goal.
Results
A total of 551 e-mail invitations were sent and opened; 205 responses were received
(response rate 37.2%). While 44.9% of surgeons reported being asked about cure in
all or most discussions, only 37.6% used the word cure as often. When discussing cure,
an equal number of surgeons reported using qualitative versus quantitative language
to express probability of cure (45.7% and 47.4%, respectively). Roughly one third
of surgeons (n = 65, 31.7%) defined cure as 5-year, disease-free survival; 36.1% (n = 74) defined cure as absence of recurrence over the patient's lifetime; and 21 (10.2%)
defined cure as return to baseline population risk for that specific cancer. Over
half of surgeons (n = 112, 56.9%) perceived that to “be cured” was among the top 2 priorities of patients
presenting for operative treatment.
Conclusion
When discussing relative benefits and goals of therapy, surgeon self-reported discussions
of cure varied considerably. Despite identifying cure as a top priority for patients,
surgeons were not inclined to incorporate cure into discussions of risks, benefits,
and goals of therapy.
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Article info
Publication history
Published online: August 04, 2016
Accepted:
June 11,
2016
Footnotes
Supported in part by the National Institutes of Health grant #T32 CA126607-07, Clinical and laboratory research training for surgical oncologists (Megan Winner, nonrestricted educational grant).
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
