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Clinical decision-making in advanced cancer is a highly complex process. Many factors are thought to influence this process arguably the most important of these is the patient's own preference. Studies show that most patients want to be fully informed as to their diagnosis and involved in clinical decision-making. However, the attitudes of healthcare workers often preclude patient involvement. Studies have also shown that acceptability of chemotherapy for minimal therapeutic gain differs markedly between patients depending on factors such as age, gender and family status. It is clearly impossible to make decisions about what is best for patients without involving them in the decision-making process. Indeed, it could be argued that active patient participation actually simplifies this process.

Assessing patients' needs and preferences in the management of advanced colorectal cancer