Decision Making in Cancer Prevention and Control

2018 ◽  
Author(s):  
Erin M. Ellis ◽  
Rebecca A. Ferrer
Keyword(s):  
Clinical Trial ◽  
Decision Making ◽  
Palliative Care ◽  
Cancer Patients ◽  
Trial Participation ◽  
Clinical Trial Participation ◽  
High Stakes ◽  
Life And Death ◽  
Fundamental Knowledge ◽  
And Control

Being diagnosed with cancer introduces the need to make many high-stakes decisions about treatments, clinical trial participation, palliative care, advanced care planning, and (sometimes) end-of-life preferences. These decisions can be intensely emotional themselves, and occur within the affectively laden context of cancer-related issues, such as symptom management, interpersonal concerns, and existential questions about life and death. This chapter outlines how affect/emotion influences several decisions faced by cancer patients, and how emotions are relevant to the interpersonal context in which these decisions occur. Emotion has pervasive and predictable—sometimes deleterious and sometimes advantageous—influences on decision making. Fundamental knowledge regarding how affect influences cancer-related decision making could be leveraged to develop interventions to optimize decisions about treatment, clinical trial participation, and palliative care among cancer patients and survivors, thereby improving cancer-related outcomes.

scholarly journals “When Offered to Participate”: A Systematic Review and Meta-Analysis of Patient Agreement to Participate in Cancer Clinical Trials

2020 ◽  
Author(s):  
Joseph M Unger ◽  
Dawn L Hershman ◽  
Cathee Till ◽  
Lori M Minasian ◽  
Raymond U Osarogiagbon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trial ◽  
Decision Making ◽  
Clinical Trials ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Cancer Control ◽  
Trial Participation ◽  
Clinical Trial Participation ◽  
Black Patients

Abstract Background Patient participation in clinical trials is vital for knowledge advancement and outcomes improvement. Few adult cancer patients participate in trials. Although patient   decision-making about trial participation has been frequently examined, the participation rate for patients actually offered a trial is unknown. Methods A systematic review and meta-analysis using 3 major search engines was undertaken. We identified studies from January 1, 2000, to January 1, 2020, that examined clinical trial participation in the United States. Studies must have specified the numbers of patients offered a trial and the number enrolled. A random effects model of proportions was used. All statistical tests were 2-sided. Results We identified 35 studies (30 about treatment trials and 5 about cancer control trials) among which 9759 patients were offered trial participation. Overall, 55.0% (95% confidence interval [CI] = 49.4% to 60.5%) of patients agreed to enroll. Participation rates did not differ between treatment (55.0%, 95% CI = 48.9% to 60.9%) and cancer control trials (55.3%, 95% CI = 38.9% to 71.1%; P = .98). Black patients participated at similar rates (58.4%, 95% CI = 46.8% to 69.7%) compared with White patients (55.1%, 95% CI = 44.3% to 65.6%; P = .88). The main reasons for nonparticipation were treatment choice or lack of interest. Conclusions More than half of all cancer patients offered a clinical trial do participate. These findings upend several conventional beliefs about cancer clinical trial participation, including that Black patients are less likely to agree to participate and that patient decision-making is the primary barrier to participation. Policies and interventions to improve clinical trial participation should focus more on modifiable systemic structural and clinical barriers, such as improving access to available trials and broadening eligibility criteria.

scholarly journals Cancer Patients' Fears Related to Clinical Trial Participation: A Qualitative Study

2012 ◽  
Vol 27 (2) ◽  
pp. 257-262 ◽  
Author(s):  
Gwendolyn P. Quinn ◽  
Alexis Koskan ◽  
Kristen J. Wells ◽  
Luis E. Gonzalez ◽  
Cathy D. Meade ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Qualitative Study ◽  
Cancer Patients ◽  
Trial Participation ◽  
Clinical Trial Participation

Patterns of decision making about cancer clinical trial participation among the online cancer treatment community: A collaboration between SWOG and NexCura.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. CRA6009-CRA6009
Author(s):  
Joseph M Unger ◽  
Dawn L. Hershman ◽  
Kenda Burg ◽  
Carol Moinpour ◽  
Kathy S. Albain ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Decision Making ◽  
Cancer Treatment ◽  
Annual Meeting ◽  
Clinical Oncology ◽  
Trial Participation ◽  
Clinical Trial Participation ◽  
Daily News ◽  
Online Supplement ◽  
Final Text

CRA6009 The full, final text of this abstract will be available at abstract.asco.org at 12:01 AM (EDT) on Sunday, June 3, 2012, and in the Annual Meeting Proceedings online supplement to the June 20, 2012, issue of Journal of Clinical Oncology. Onsite at the Meeting, this abstract will be printed in the Sunday edition of ASCO Daily News

scholarly journals Are cancer patients better off if they participate in clinical trials? A mixed methods study

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zandra Engelbak Nielsen ◽  
Stefan Eriksson ◽  
Laurine Bente Schram Harsløf ◽  
Suzanne Petri ◽  
Gert Helgesson ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Mixed Methods ◽  
Literature Review ◽  
Cancer Patients ◽  
Standard Care ◽  
Rapid Development ◽  
Trial Participation ◽  
Clinical Trial Participation ◽  
Positive Effects

Abstract Background Research and cancer care are closely intertwined; however, it is not clear whether physicians and nurses believe that clinical trials offer the best treatment for patients and, if so, whether this belief is justified. The aim of this study was therefore: (i) to explore how physicians and nurses perceive the benefits of clinical trial participation compared with standard care and (ii) whether it is justified to claim that clinical trial participation improves outcomes for cancer patients. Methods A mixed methods approach was used employing semi-structured interviews with 57 physicians and nurses in oncology and haematology and a literature review of the evidence for trial superiority, i.e. the idea that receiving treatment in a clinical trial leads to a better outcome compared with standard care. Inductive thematic analysis was used to examine the interview data. A literature review comprising nine articles was conducted according to a conceptual framework developed by Peppercorn et al. and evaluated recent evidence on trial superiority. Results Our findings show that many physicians and nurses make claims supporting trial superiority, however very little evidence is available in the literature comparing outcomes for trial participants and non-participants that supports their assertions. Conclusions Despite the recent rapid development and use of targeted therapy and immunotherapy, we find no support for trial participation to provide better outcomes for cancer patients than standard care. Hence, our present results are in line with previous results from Peppercorn et al. A weaker version of the superiority claim is that even if a trial does not bring about a direct positive effect, it brings about indirect positive effects. However, as the value of such indirect effects is dependent on the individual’s specific circumstances and preferences, their existence cannot establish the general claim that treatment in trials is superior. Belief in trial superiority is therefore unfounded. Hence, if such beliefs are communicated to patients in a trial recruitment context, it would provide misleading information. Instead emphasis should be on patients volunteering to give an altruistic contribution to the furthering of knowledge and to the potential benefit of future patients.

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