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Prioritizing treatment outcomes: Head and neck cancer patients versus nonpatients
Author(s) -
List Marcy A.,
Rutherford Judith Lee,
Stracks John,
Pauloski Barbara Roa,
Logemann Jerilyn A.,
Lundy Donna,
Sullivan Paula,
Goodwin William,
Kies Merrill,
Vokes Everett E.
Publication year - 2004
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.10367
Subject(s) - medicine , head and neck cancer , distress , head and neck , cancer , surgery , clinical psychology
Background. Treatment decisions in head and neck cancer (HNC) might involve consideration of uncertain tradeoffs of one late effect against another or increasing toxicity or residual impairment for increased chance of survival. Understanding how patients prioritize potential outcomes, as well as whether these preferences are similar to those of nonpatients, is important to informed decision making and treatment planning. Methods. Two hundred forty‐seven newly diagnosed HNC patients from nine institutions and 131 nonpatients rank ordered a set of 12 potential treatment outcomes (eg, cure; being able to swallow; normal voice) from highest (1) to lowest (12). Results. Patients and nonpatients were similar with respect to the three items most frequently ranked in the top three, that is, “being cured of cancer,” “living as long as possible,” and “having no pain” in that order. In contrast, patients more frequently ranked “cure” (90% vs 80%) and less frequently ranked “no pain” (34% vs 52%) in the top three. Conclusions. Survival seems to be of paramount importance to both patient and nonpatient groups, overshadowing associated toxicities and potential dysfunction. At the same time, patients might be more willing than nonpatients to undergo aggressive treatments and endure acute distress in the interest of potential long‐term gains (ie, cure or longer survival). © 2004 Wiley Periodicals, Inc. Head Neck 26: 163–170, 2004