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Do patients with schizophrenia receive state‐of‐the‐art lung cancer therapy? A brief report
Author(s) -
Mateen Farrah J.,
Jatoi Aminah,
Lineberry Timothy W.,
Aranguren Dawn,
Creagan Edward T.,
Croghan Gary A.,
Jett James R.,
Marks Randolph S.,
Molina Julian R.,
Richardson Ronald L.
Publication year - 2008
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.1303
Subject(s) - medicine , lung cancer , schizoaffective disorder , schizophrenia (object oriented programming) , cancer , radiation therapy , disease , health care , intensive care medicine , psychiatry , psychosis , economics , economic growth
Objective : Patients with schizophrenia sometimes receive substandard medical care. This study explored such disparities among lung cancer patients with underlying schizophrenia. Methods : This retrospective study focused on patients with pre‐existing schizophrenia (or in some instances schizoaffective disorder) and a lung cancer diagnosis made between 1980 and 2004. ‘Disparity’ was defined as a patient's having been prescribed less aggressive therapy for a potentially curable cancer based on state‐of‐the‐art treatment standards for the time and for the cancer stage. Qualitative methods were used to assess healthcare providers' decision‐making. Results : 29 patients were included. The median age was 59 years; 38% were men. Twenty‐three had non‐small cell lung cancer and 6 small cell lung cancer; 17 had potentially curable cancers. Five of 17 had a ‘disparity’ in cancer care: (1) no cancer therapy was prescribed because of chronic obstructive pulmonary disease; (2) no cancer therapy was prescribed because of infection; (3) no chemotherapy was prescribed because the patient declined it; radiation was provided; (4) no chemotherapy was prescribed because of the patient's schizophrenia symptoms; radiation was administered; and (5) no surgery was performed because of disorientation from a lobotomy; radiation was prescribed. Comments from healthcare providers suggest reflection and ethical adjudication in decision‐making. Conclusion : Schizophrenia was never the sole reason for no cancer treatment in patients with potentially curable lung cancer. This study provides the impetus for others to begin to assess the effect of schizophrenia on lung cancer management in other healthcare settings. Copyright © 2007 John Wiley & Sons, Ltd.