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Walming S, Asplund D, Block M, Bock D, Gonzalez E, Rosander C, Rosenberg J, Angenete E. Patients with rectal cancer are satisfied with in-hospital communication despite insufficient information regarding treatment alternatives and potential side-effects. Acta Oncol 2018; 57:1311-1317. [PMID: 29989469 DOI: 10.1080/0284186x.2018.1484158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AIM Patients with rectal cancer may undergo treatment such as surgery and (chemo)radiotherapy. Before treatment, patients are informed of different options and possible side-effects. The aim of the study was to evaluate the patients' experience of communication with healthcare personnel at time of diagnosis and after one year. METHOD A total of 1085 patients from Denmark and Sweden were included. They answered a detailed questionnaire at diagnosis and at the one year follow-up. Clinical data were retrieved from national quality registries. RESULTS Response rates were 87% at baseline and 74% at one year. Overall the patients were very satisfied with the communication with healthcare personnel. However, some patients reported insufficient information regarding treatment options and possible side-effects. Only 32% (335/1050) and 24% (248/1053), respectively, stated that they were informed about possible sexual and urinary dysfunction before treatment. CONCLUSIONS Even though patients felt that they received insufficient information regarding side-effects on sexual and urinary function, they were generally satisfied with the communication with the healthcare personnel. Since overall satisfaction with the level of information was very high, it is unlikely that further information to patients with rectal cancer in the surgical and oncological settings will improve satisfaction with communication.
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Affiliation(s)
- Sofie Walming
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG – Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Dan Asplund
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG – Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Mattias Block
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG – Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - David Bock
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG – Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Elisabeth Gonzalez
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG – Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Carina Rosander
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG – Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Jacob Rosenberg
- Department of Surgery, Herlev Hospital, Denmark and Danish Colorectal Cancer Group, Herlev, Denmark
| | - Eva Angenete
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, SSORG – Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
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Pinto E, Cavallin F, Saadeh LM, Bellissimo MC, Alfieri R, Mantoan S, Cagol M, Castoro C, Scarpa M. Potential curability and perception of received information in esophageal cancer patients. Support Care Cancer 2017; 26:1807-1814. [PMID: 29260389 DOI: 10.1007/s00520-017-4005-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 12/05/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed to evaluate patients' perceived receipt of information according to the possibility of cure in esophageal cancer. METHODS One hundred and twelve consecutive patients presenting at the multidisciplinary visit at the Veneto Institute of Oncology for esophageal cancer between 2014 and 2016 were included in the study. The Italian version of the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaires C30 (core questionnaire), OG25 (esophago-gastric cancer module), and INFO25 (information module) were used. RESULTS Candidates for palliative treatment were less informed about the disease (adjusted mean difference - 11.5, 95% CI - 23.0 to - 0.02) and less satisfied with information provided (adjusted mean difference - 18.3, 95% CI - 31.9 to - 4.7) than candidates for curative treatment. In addition, candidates for palliative treatment wanted to receive more information than candidates for curative treatment (adjusted mean difference 26.1, 95% CI 0.5 to 51.6). Better quality of life was associated with satisfaction of received information (β = 0.77, p < 0.0001) and of receiving information about things that the patient can do to help himself (β = 0.26, p = 0.04). More anxiety was associated to receiving more information about disease (β = 0.46, p = 0.02) but less information about things that the patient can do to help himself (β = - 0.38, p = 0.02). CONCLUSIONS Candidates for palliative treatment were less satisfied with information about the disease and wanted to receive more information. Additionally, some aspects of quality of life were found to be associated with perceived receipt of information. Appropriate training in communication of prognostic information may improve clinical management of incurable cancer patients.
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Affiliation(s)
- Eleonora Pinto
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Francesco Cavallin
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Luca Maria Saadeh
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Maria Cristina Bellissimo
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Rita Alfieri
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Silvia Mantoan
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Matteo Cagol
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Carlo Castoro
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy
| | - Marco Scarpa
- Esophageal and D igestive Tract Surgical Unit, Regional Centre for Esophageal Disease, Veneto Oncological Institute (IOV-IRCCS), via Gattamelata 64, 35128, Padova, Italy.
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Rønde HS, Wee L, Pløen J, Appelt AL. Feasibility of preference-driven radiotherapy dose treatment planning to support shared decision making in anal cancer. Acta Oncol 2017; 56:1277-1285. [PMID: 28447539 DOI: 10.1080/0284186x.2017.1315174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE/OBJECTIVE Chemo-radiotherapy is an established primary curative treatment for anal cancer, but clinically equal rationale for different target doses exists. If joint preferences (physician and patient) are used to determine acceptable tradeoffs in radiotherapy treatment planning, multiple dose plans must be simultaneously explored. We quantified the degree to which different toxicity priorities might be incorporated into treatment plan selection, to elucidate the feasible decision space for shared decision making in anal cancer radiotherapy. MATERIAL AND METHODS Retrospective plans were generated for 22 anal cancer patients. Multi-criteria optimization handles dynamically changing priorities between clinical objectives while meeting fixed clinical constraints. Four unique dose distributions were designed to represent a wide span of clinically relevant objectives: high-dose preference (60.2 Gy tumor boost and 50.4 Gy to elective nodes with physician-defined order of priorities), low-dose preference (53.75 Gy tumor boost, 45 Gy to elective nodes, physician-defined priorities), bowel sparing preference (lower dose levels and priority for bowel avoidance) and bladder sparing preference (lower dose levels and priority for bladder avoidance). RESULTS Plans satisfied constraints for target coverage. A senior oncologist approved a random subset of plans for quality assurance. Compared to a high-dose preference, bowel sparing was clinically meaningful at the lower prescribed dose [median change in V45Gy: 234 cm3; inter-quartile range (66; 247); p < .01] and for a bowel sparing preference [median change in V45Gy: 281 cm3; (73; 488); p < .01]. Compared to a high-dose preference, bladder sparing was clinically meaningful at the lower prescribed dose [median change in V35Gy: 13.7%-points; (0.3; 30.6); p < .01] and for a bladder sparing preference [median change in V35Gy: 30.3%-points; (12.4; 43.1); p < .01]. CONCLUSIONS There is decision space available in anal cancer radiotherapy to incorporate preferences, although tradeoffs are highly patient-dependent. This study demonstrates that preference-informed dose planning is feasible for clinical studies utilizing shared decision making.
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Affiliation(s)
- Heidi S. Rønde
- Department of Medical Physics, Vejle Hospital, Vejle, Denmark
| | - Leonard Wee
- MAASTRO Clinic, School of Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
- Danish Colorectal Cancer Centre South, Vejle Hospital, and Institute of Regional Health Research, University of Southern Denmark, Denmark
| | - John Pløen
- Danish Colorectal Cancer Centre South, Vejle Hospital, and Institute of Regional Health Research, University of Southern Denmark, Denmark
- Department of Oncology, Vejle Hospital, Vejle, Denmark
| | - Ane L. Appelt
- Danish Colorectal Cancer Centre South, Vejle Hospital, and Institute of Regional Health Research, University of Southern Denmark, Denmark
- Leeds Institute of Cancer and Pathology, University of Leeds, and Leeds Cancer Centre, St. James' University Hospital, Leeds, UK
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Böckelman C, Glimelius B. Need for adjuvant chemotherapy after colon cancer surgery - has it decreased? Acta Oncol 2017; 56:629-633. [PMID: 28447563 DOI: 10.1080/0284186x.2017.1317924] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Camilla Böckelman
- Department of Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Research Programs Unit, University of Helsinki, Helsinki, Finland
| | - Bengt Glimelius
- Department of Immunology, Genetics and Pathology, University of Uppsala, Uppsala, Sweden
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