Patient Preference Doesn't Affect Chemo in Advanced CRC

Most advanced colorectal cancer patients receive chemotherapy even if they doubt the benefits

FRIDAY, Sept. 21 (HealthDay News) -- For patients with metastatic colorectal cancer (mCRC), most patients are treated with chemotherapy, even if they express negative or marginal preferences, according to a study published online Sept. 12 in Cancer.

S. Yousuf Zafar, M.D., M.H.S., of the Duke Cancer Institute in Durham, N.C., and colleagues conducted a prospective cohort study involving 702 patients with mCRC to determine how patient preferences guide the course of palliative chemotherapy.

Overall, 91 percent of patients were treated by a medical oncologist, and 82 percent of these received chemotherapy. The researchers found that patients aged 65 to 75 years or 75 years and older were less likely to visit an oncologist, as were those who were too unwell to complete their own survey. Patients who were 75 years or older with moderate or severe comorbidities or patients who were too unwell to complete their own survey were less likely to receive chemotherapy. Patients tended to receive chemotherapy even when they felt that treatment would not extend their lives (90 percent) or help them with their cancer-related problems (89 percent), and even when they stated a preference to focus on comfort rather than extending their life (90 percent).

"In summary, treatment decisions in the palliative setting were not always congruent with stated preferences and beliefs regarding chemotherapy," the authors write. "The vast majority of patients who expressed negative or marginal preferences or beliefs regarding chemotherapy still received chemotherapy. Patient preferences and beliefs were not associated with the intensity or number of chemotherapy regimens received."

Several authors disclosed financial ties to the pharmaceutical industry.

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