Choice 'confuses cancer patients'

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Cancer patients can often feel baffled when offered a choice of treatments, a study has suggested.

The Cancer Research UK work, which looked at a group of 43 ovarian cancer patients, found they felt confused and concerned when offered options.

They felt particularly "abandoned" when doctors did not offer their own suggestions about what they should do.

Cancer experts said doctors must give patients as much guidance as possible in deciding their care.

It is essential that doctors help their patients to understand as far as possible the medical advice offered rather than let them feel that treatment choices are a burden for them to shoulder alone Professor John Toy, Cancer Research UK

Most women said they went along with the doctor's recommendation often because everything was happening too quickly to seek further information or because they felt "too shocked and too ill and too desperate to survive".

A second group asked questions or sought second opinions but decided to agree with the doctor's suggestion because they felt there was no "real choice" if they wanted to survive.

The third, smallest group said they had made at least some of their treatment decisions themselves - such as, in some cases, even declining further treatment.

Some women said that when they were offered a choice of treatment they felt unprepared and panicky about making the right decision, thought it was bizarre to be asked and tried to second guess what they thought the doctor wanted them to do.

'Shock and surprise'

Dr Sue Ziebland, who led the study, said: "Patient choice is an important issue.

"But this in-depth interview study illustrates the confusion among patients and doctors about how to share decision-making in cancer treatment."

One patient who took part in the study said she was told: "There are two chemotherapies you can have; you can have just one or you can have both. What do you want?"

She said she could not understand why she was presented with an option when she was in a "traumatised state" having been recently diagnosed.

Dr Ziebland added: "The study shows that being asked about treatment preferences can surprise or shock women.

"Clinicians need to explain about clinical uncertainty and how an individual's values and preferences may relate to what treatments they want to have.

"Options should be communicated clearly, differences in opinion should be acknowledged and the doctors should state their preferences.

"Patients should also be reassured that whatever decision they might chose to make, their relationship with the medical team will not be affected."

Professor John Toy, medical director of Cancer Research UK, said: "It is now, quite rightly, common practice to include patients as active participants when discussing their treatment options.

"But it is essential that doctors help their patients to understand as far as possible the medical advice offered rather than let them feel that treatment choices are a burden for them to shoulder alone."