Decision making in older patients with advanced cancer: does doctor know best?

Lakshmi P Venkateswaran, Phyllis N Butow, Jesse Jansen, Nicholas R C Wilcken, Mark K Wong, Rina Hui, George Szonyi, Val J Gebski, Vasi Naganathan, Lisa G Horvath and Martin H N Tattersall
Med J Aust 2012; 196 (1): . || doi: 10.5694/mja11.10907
Published online: 16 January 2012

To the Editor: The median age of Australian patients at first diagnosis of cancer is 67.8 years.1 In advanced, incurable cancer, goals of treatment include symptom control for all patients and prolongation of survival by weeks to months in a subgroup. In older people, treatment decisions can be complicated by comorbidities, polypharmacy, frailty and cognitive impairment. Few studies have investigated older patients’ information needs and preferences for involvement in decisions about their care.2,3 We performed an exploratory study to investigate whether the health status of older cancer patients predicted their information needs, decision preferences and their oncologists’ treatment recommendations. Concordance between patients’ stated preferences and the perceptions of their oncologists was also measured.

  • Lakshmi P Venkateswaran1
  • Phyllis N Butow2
  • Jesse Jansen2
  • Nicholas R C Wilcken2
  • Mark K Wong1
  • Rina Hui1
  • George Szonyi3
  • Val J Gebski2
  • Vasi Naganathan2
  • Lisa G Horvath3
  • Martin H N Tattersall2

  • 1 Westmead Hospital, Sydney, NSW.
  • 2 University of Sydney, Sydney, NSW.
  • 3 Royal Prince Alfred Hospital, Sydney, NSW.


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