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The information and decision support needs of older women (>75 yrs) facing treatment choices for breast cancer: a qualitative study
Author(s) -
Burton Maria,
Collins Karen Anna,
Lifford Kate Joanna,
Brain Kate,
Wyld Lynda,
Caldon L.,
Gath Jacqui,
Revell Deirdre,
Reed Malcolm William
Publication year - 2015
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.3735
Subject(s) - breast cancer , medicine , qualitative research , family medicine , decision aids , disease , information needs , gynecology , gerontology , cancer , nursing , alternative medicine , pathology , social science , sociology , world wide web , computer science
Objective Primary Endocrine Therapy (PET) is a good alternative to surgery for breast cancer in older frailer women. Overall survival rates are equivalent although rates of local control are inferior. There is little research regarding the decision support needs of older patients faced with this choice. This qualitative study aimed to explore these among older breast cancer patients offered a choice of treatment, as the basis to develop an appropriate decision support tool. Methods Semi‐structured interviews were undertaken with older women (>75 years) with breast cancer who had been offered a choice of PET or surgery at diagnosis. Women's involvement in their treatment decision and support for the process were explored and analysed using framework analysis. Results Thirty‐three interviews were undertaken (median age 82, range 75–95 years, 22 PET, 11 surgery). Most women, regardless of treatment choice, wanted tailored information about the different treatment options, their impact on independence, the practicalities of treatment and the risk of recurrence and spread. Surgery was the treatment of choice in women wanting optimal disease control; those choosing PET felt that they were ‘too old’ for surgery and wanted minimal disruption. Conclusions Older women described making active treatment decisions. However, some knowledge was inaccurate. Women wanted information and decision support from their clinicians along with a specific tailored information booklet to support this process. Copyright © 2014 John Wiley & Sons, Ltd.