Effect of endurance for adverse drug reactions on the preference for aggressive treatments in cancer patients

• Published in: Supportive care in cancer Vol. 23; no. 4; pp. 1091 - 1097
• Main Authors: Iihara, Naomi, Nishio, Takayuki, Goda, Tetsuko, Anzai, Hideaki, Kagawa, Masatoshi, Houchi, Hitoshi, Kirino, Yutaka
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2015; Springer; Springer Nature B.V
• Subjects: Activities of daily living; Adaptation, Psychological; Adult; Aged; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Cancer; Cancer patients; Chemotherapy; Cross-Sectional Studies; Decision Making; Drug therapy; Drug-Related Side Effects and Adverse Reactions; Drugs; Female; Health aspects; Hospitals; Humans; Japan; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasms - drug therapy; Neoplasms - psychology; Nursing; Nursing Research; Oncology; Original Article; Pain Medicine; Patient Preference; Preferences; Prognosis; Rehabilitation Medicine; Side effects; Survival Analysis; Survivors - psychology; Treatment Outcome; Japan; Chemotherapy; Drug-related side effects and adverse reactions; Patient preference; Decision making
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-014-2439-1

Purpose Cancer patients receiving chemotherapy will sometimes conceal their discomfort, but an excessive endurance for adverse drug reactions (ADRs) can lead to a poorer prognosis. The aim of this study was to clarify the association between ADR endurance and a preference of cancer patients for aggressive treatments. Methods A cross-sectional study was undertaken of inpatients under 75 years of age receiving injectable systemic chemotherapy or oral chronic medications at hospitals in Japan. Subjects were asked to respond to a validated questionnaire to assess the extent of their ADR endurance and whether they would choose a novel, more aggressive therapy if their life expectancy was estimated at 2 years. Results Study participants were separated into the chemotherapy group ( n  = 36) and the non-chemotherapy group ( n  = 78). In the chemotherapy group, patients who had moderate ADR endurance scores were more likely to choose the new therapy (0–33, 34–67, and 68–100 points: 0.0, 54.5, and 27.3 %; χ 2 test, p  = 0.15). Additionally, every patient on long-term chemotherapy (≥3 years) had high ADR endurance scores but did not choose the new, riskier treatment. In the non-chemotherapy group, the proportion of those choosing the new therapy was linearly associated with higher ADR endurance scores (25.9, 38.2, and 64.7 %; p  = 0.04). Conclusion Cancer patients may prefer aggressive therapies, even when self-estimations of ADR endurance are not very high, especially if they have been receiving chemotherapy for a short period of time. These patients should be observed with great caution.