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It's a choice to move forward: women's perceptions about treatment decision making in recurrent ovarian cancer
Authors:L. Elit  C. Charles  S. Dimitry  S. Tedford‐Gold  A. Gafni  I. Gold  T. Whelan
Affiliation:1. Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ont., Canada;2. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont., Canada;3. Supportive Cancer Care Unit, Juravinski Cancer Centre, Hamilton, Ont., Canada;4. Core Research and Consulting, Ottawa, Ont., Canada;5. Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ont., Canada;6. Association of Faculties of Medicine of Canada, Ottawa, Ont., Canada
Abstract:Objective: This research explores the treatment decision‐making (TDM) experiences of women with recurrent ovarian cancer (ROC) with regard to treatment options; their understanding of risks and benefits of various treatment options; the decision‐making role they want for themselves and for their oncologist; and the social context of the consultation as it pertains to the decision. Methods: We conducted semi‐structured interviews with 26 women at the time of first recurrence. Through inductive data analysis key themes were identified. Results: Many women describe self‐identifying the cancer recurrence fairly quickly due to new symptoms. Many feel that the goal for treating their recurrence is to control versus cure the cancer. They describe the subsequent process of diagnosis and TDM for ROC as quick and straightforward with all women accepting the oncologists' treatment recommendation. They feel that the type and number of treatment options are limited. They have a strong desire for physician continuity in their care. Participants feel that their doctor's recommendations as well as their previous experience with ovarian cancer are strong factors influencing their current TDM process. Conclusions: Shared decision making is based on a simultaneous participation of both the physician and patient in TDM. When faced with ROC, women feel that their doctor's recommendation and their past experience with treatment and TDM are prominent factors influencing the current TDM process. Copyright © 2009 John Wiley & Sons, Ltd.
Keywords:cancer  oncology  treatment decision making  recurrent ovarian cancer  qualitative research
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