Choices in cancer treatment: a qualitative study of the older women's (>70 years) perspective

Psycho-Oncology - Tập 17 Số 4 - Trang 410-416 - 2008
Lopa Sadia Husain1, Karen Collins1, Malcolm Reed1, Lynda Wyld1
1Academic Surgical Oncology Unit, University of Sheffield, Sheffield, UK

Tóm tắt

AbstractPurpose: Primary endocrine therapy (PET) is the treatment of primary, operable breast cancer with drugs, such as tamoxifen, rather than surgery. It is in widespread use in the UK with 40% of women over 70 years old being treated in this way. PET is associated with inferior rates of local control compared with the standard surgical therapies, but there is no difference in overall survival. There has been no published research regarding the attitudes of older women concerning these two alternative approaches to treatment; what may influence their treatment choice or their experience of either treatment modality. This study aimed to address these questions.Method: In‐depth qualitative interviews were undertaken to explore the views of a group of 21 purposively selected older women (>70 years old), who had been treated by PET or surgery for breast cancer. The interviews were transcribed verbatim and analysed using Framework Analysis.Results: Both surgery and PET were well tolerated and had high satisfaction ratings from most women. This was the case even for those who had complications following surgery or needed a change of management in the PET group. Older women expressed no age‐specific fears for operative procedures. The women were passive information seekers and relied heavily on ‘expert’ advice in making their treatment choices. Neither social support or age were factors in their decision‐making. Their main concern was to ensure that their quality of life and independence remained unaffected.Conclusion: Older women have no strong preference for either treatment option but are concerned that the treatment is effective and causes minimal disruption to their quality of life and independence. This study suggests that medical consultations may need to be adapted to reflect the passive acceptance of ‘expert’ advice in the majority of women in this age group. Copyright © 2007 John Wiley & Sons, Ltd.

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Tài liệu tham khảo

10.1001/jama.285.7.885

Gaudagnoli E, 1997, Age related patterns of care: evidence against ageism in the treatment of early stage breast cancer, J Clin Oncol, 15, 2338, 10.1200/JCO.1997.15.6.2338

MonypennyI. UK Symptomatic Breast Audit 1.4. 2001–31.3. 2002. British Association of Surgical Oncology 2003.

10.1038/sj.bjc.6601742

Hind D, 2006, The Cochrane Library

10.1002/bjs.4603

10.1093/annonc/mdg117

Gazet J‐C, 1994, Prospective randomised trial of tamoxifen vs surgery in elderly patients with breast cancer, Eur J Surg Oncol, 20, 207

Fallowfield LJ, 1994, Psychological effect of being offered choice of surgery for breast cancer, Br Med J, 309, 31

10.1046/j.1369-6513.2001.00119.x

10.1016/0277-9536(94)90336-0

10.1097/00006199-199301000-00005

10.1136/bmj.38046.771308.7C

10.1200/JCO.2002.20.4.1008

Ritchie J, 2003, Qualitative Research Practice

10.1016/0022-3956(75)90026-6

Steginga S, 1998, Domains of distress: the experience of breast cancer in Australia, Oncol Nurs Forum, 25, 1064

10.1093/geront/34.4.505

10.1046/j.1365-2648.1999.00912.x

10.1097/00002820-200312000-00002

10.1046/j.1365-2648.1997.1997026059.x

10.1046/j.1365-2648.2001.01806.x

Lee CO, 1997, Quality of life and breast cancer survivors, Cancer Pract, 5, 309

10.1188/04.ONF.1153-1159

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Psycho-Oncology

Tập 17 Số 4

410-416

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