Shared decision-making in palliative care: desires and facts
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A 45-year-old female piano teacher with stage III colorectal carcinoma (CRC) refuses oxaliplatin next to capecitabin as adjuvant treatment, as playing piano constitutes her “life and job.” A 79-year-old man, performance status WHO 1–2, with metastasized CRC with only short-lasting response and multiple grade II/III toxicities on first and second-line treatment, demands for third-line treatment as he wishes to prolong survival in order to continue care for his wife.
How do we, as medical oncologists, cope with these considerations in the era of shared decision-making (SDM)? What probably matters most is being well informed regarding treatment options in order to make the right decisions. If we inform the first patient about the gain of oxaliplatin and the chance of losing her job because of neuropathy, it is not more than overall statistics, sometimes difficult to apply for patients to themselves. And how do we act on choices if we are patients ourselves? A cardiothoracic surgeon ...
- 4.Stacey D, Legare F, Lewis K, Barry MJ, Bennett CL, Eden KB, Holmes-Royner M, Llewellyn-Thomas H, Lyddiatt A, Thomson R, Trevena L 2017. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev;(4):CD001431. https://doi.org/10.1002/14651858.CD001431.pub.5