Best of ASCO - 2014 Annual Meeting



Attend this session at the
2017 ASCO Annual Meeting!

Session: Patient and Survivor Care

Type: Poster Session

Time: Saturday June 3, 1:15 PM to 4:45 PM

Location: Hall A

Risk tolerance and attitudes toward chemotherapy: Who chooses palliative treatment when cure is possible?

Psychosocial Research

Patient and Survivor Care

2017 ASCO Annual Meeting

Abstract No:

Poster Board Number:
Poster Session (Board #43)

J Clin Oncol 35, 2017 (suppl; abstr 10054)

Author(s): Thomas William LeBlanc, Karen Scherr, Annabel Wang, Monica Lemmon, Peter A. Ubel; Duke Cancer Institute, Duke University Medical Center, Durham, NC; Duke University School of Medicine, Durham, NC; Duke University Fuqua School of Business, Durham, NC

Abstract Disclosures


Background: Many patients with acute myeloid leukemia (AML) face a difficult choice about whether to receive palliative chemotherapy or high-dose, potentially-curative chemotherapy that poses a risk of early death. How people weigh these factors in decision-making is unknown. We hypothesized that the possibility of cure primarily drives decision-making, regardless of treatment risk. Methods: We designed an electronic survey describing two treatment paths: (1) high-dose chemotherapy with possibility of cure but a 10% risk of early death, and (2) palliative chemotherapy with no chance of cure but no risk of early death. We recruited respondents via Amazon MTurk and presented 7 scenarios in random order, varying only the likelihood of cure associated with high-dose chemotherapy. Subjects rated their preferred treatment on a 4-point Likert scale. We assessed numeracy and attitudes toward chemotherapy using validated scales, and employed attention checks for quality assurance. Results: 100 subjects completed the survey (median age 30.5; 52 female, 85 Caucasian). 46 (46%) had at least a bachelor’s degree and numeracy was generally high (median 4.75 out of 6). Respondents’ preferences for intensive chemotherapy varied with likelihood of cure, however some displayed a fixed preference for either curative or palliative treatment throughout, regardless of benefit level. For example, given a 50% likelihood of cure 20 respondents (20%) still preferred palliative therapy; similarly, with only a 1% likelihood of cure 28 respondents (28%) still preferred high-dose chemotherapy. In a multivariable model, preference for palliative chemotherapy was significantly predicted by subjects’ scores on the attitudes toward chemotherapy scale (p < 0.001), controlling for age, education, and numeracy. Conclusions: Contrary to our hypothesis, a significant proportion of subjects preferred palliative chemotherapy, even in scenarios where high-dose chemotherapy confers a high likelihood of cure. Pre-existing attitudes toward chemotherapy appear to drive patients’ decision-making, even when treatments are potentially curative. This finding may have significant implications for risk communication in oncology.

Other Abstracts in this Sub-Category:


1. Web-based stress management for newly diagnosed cancer patients (STREAM): A randomized, wait-list controlled intervention study.

Meeting: 2017 ASCO Annual Meeting Abstract No: LBA10002 First Author: Viviane Hess
Category: Patient and Survivor Care - Psychosocial Research


2. Randomized trial of a cognitive-behavioral therapy mobile app for anxiety in patients with incurable cancer.

Meeting: 2017 ASCO Annual Meeting Abstract No: 10022 First Author: Joseph Greer
Category: Patient and Survivor Care - Psychosocial Research


3. Cancer-related fatigue in breast cancer survivors: A longitudinal analysis compared to matched controls.

Meeting: 2017 ASCO Annual Meeting Abstract No: 10045 First Author: AnnaLynn Williams
Category: Patient and Survivor Care - Psychosocial Research