Which factors contribute to decisional conflict of patients with incurable cancer?

Published on March 31, 2022 – Patients’ global health status, satisfaction with the consultation with the oncologist, and timing of the decision together contribute to decisional conflict. Liza van Lent (Erasmus MC Cancer Institute), Julia van Weert (ACHC) and colleagues conclude so in a prospective survey study among 116 patients with incurable cancer. 

When patients with incurable cancer have no standard treatment options anymore, they can sometimes decide to participate in early phase clinical trials. These are experimental treatments with uncertain outcomes, which makes the decision to participate or not quite complex. Improving this decision-making process can contribute to quality of life for patients with limited life expectancy. In this publication, several factors were untangled that may contribute to decisional conflict, which reflects the extent to which patients experience unresolved decisional needs, such as feelings of insecurity about the decision, in this decision.

The study suggests that effective, patient-centred communication could potentially prevent decisional conflict for patients contemplating participation in early phase clinical trials. Besides, the study showed that patients with lower global health status and those who need more time to make a decision report more decisional conflict, and may thus require additional support in their decision-making process.

The research project is led by the Erasmus MC Cancer Instituut, Radboudumc and University of Amsterdam/ASCoR, and is conducted in the Erasmus MC Cancer Institute, Antoni van Leeuwenhoek/Netherlands Cancer Institute and UMC Utrecht. The project is financed by the Dutch Cancer Society.

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