Patients' Perspectives On Refusing Diagnosis Or Treatment For Lung Cancer

[Giraffe]

‘A LITTLE BITTY SPOT AND I’M A BIG MAN’:
PATIENTS’ PERSPECTIVES ON REFUSING DIAGNOSIS OR TREATMENT FOR LUNG CANCER

To explore why patients refused recommendations for further diagnosis or treatment of lung cancer nine of those "non adherent" patients were interviewed. I do not agree with every conclusion of the authors of this study, but it's an interesting read nevertheless.

A few of the answers:

• . . . I just seen a spot on the X-ray. A little bitty spot and I’m a big man. It’d take a lot to pull me down. (9)
• Common sense. I don’t want to get cut if I don’t need to get cut. (2)
• Doctors have a bad habit of wanting to experiment. They’re mostly young doctors and they want to find out things. . . . They don’t give a damn about you personally, whether you get well or not. (4)
• They need to communicate more with the patient on what to expect, not only about the disease, but educate them on the treatments. (7)
• I went down to talk to this guy that does that kind of stuff. And he told me that’s what I had. And then,right away they started bugging me about taking treatments. (4)
• I didn’t want the chemo and to be sick, and you know, in the long run that’s not going to do any good except maybe prolong my life by maybe a few months. (7)
• . . . .anyway she ended up sending me to a cancer treatment doctor and he also lied to me. He told me what he could do for me and everything, but he didn’t bother to tell me the side-effects, the damage it was going to do. (9)
• I’ve got all of em’s names written down in a notebook because I sometimes have trouble remembering these doctors, especially when you see a dozen of them, you know? (7)

From the discussion of the results:

" An unanticipated finding of this study was that none of the patients who refused medical recommendations indicated that they had discussions with their physicians about what future symptoms they might experience with no treatment, nor were options for palliative care mentioned. Even when therapy is futile in terms of cure or prolonged survival, resources for palliation seems a good reason for physicians to continue efforts to engage with these patients."

....

In the introduction they write:

"Non-small cell lung cancer has a median survival of 6–12 months and a 5-year survival of 10–15%. Nevertheless, surgical treatment offers a chance for cure in early stage disease with 5-year survival of 40–50%, and recent studies indicate that chemotherapy for palliation of incurable advanced non-small cell lung cancer offers slight improvement in survival length and may improve quality of life (Non-small Cell Lung Cancer Collaborative Group, 1995; Cullen et al., 1999).

I couldn't find the full text of that study they referenced, but (given the object of that study) I doubt that the figures for survival time without treatment are reliable: Does anyone know about data?

 

[ecstatichamster]

It's impossible to find because the causes of death from cancer TREATMENT are attributed to something else, almost never the cancer treatment that actually killed the person.

I'm reading this
Rejecting cancer treatment: What are the consequences? « Science-Based Medicine

Has some good studies it's pointing to.

 

[Giraffe]

Thanks hamster. I am particularly interested in survival rates in lung cancer.

the causes of death from cancer TREATMENT are attributed to something else, almost never the cancer treatment that actually killed the person.

True, it doesn't make sense to look at "response to the treatment" (as in the tumor did not increase in size after treatment). What matters is overall mortality and life quality.

 

[Blossom]

Thanks hamster. I am particularly interested in survival rates in lung cancer.


True, it doesn't make sense to look at "response to the treatment" (as in the tumor did not increase in size after treatment). What matters is overall mortality and life quality.

You might find some helpful information on this site.
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