Patients With Advanced Cancer May Not Have Same End-of-Life Perspective As Their Physicians

Daniel Rocke, MD Medical School University of Michigan Medical School Ann Arbor, Interview with
Daniel Rocke, MD
Duke Medicine
Department Otolaryngology

MedicalResearch: What are the main findings of the study?

Dr. Rocke: I think the main point is that, to quote the paper, “end-of-life decision making by patients with cancer and their caregivers is significantly affected by their preference for quality of life or quantity of life, but OHNS physicians’ decision making is not.” This is important because physicians counseling patients making end-of-life decisions are coming at these decisions from a different perspective that may not line up with their patients. If physicians recognize this, I think that these end-of-life discussions can be more productive

MedicalResearch: Were any of the findings unexpected?

Dr. Rocke: We assumed that both groups would be affected by baseline attitudes. It was interesting that the physicians were not, and we have suggested that the experience of having cancer may lead people to think about questions of quality of life vs quantity of life in ways that those who have never had cancer may not have.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Rocke: I think it’s something for physicians to keep in mind when having discussions with patients – physicians don’t have the same baseline attitudes as their patients and if physicians assume that their perspective is the same as their patients, this may lead to less effective discussion.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Rocke: We suggested why there were these differences, but we don’t know. We also don’t know how these differences affect end-of-life discussions in the real world. We took a snapshot of lots of physicians, but these discussions are intensely personal. These differences may not matter in these one-on-one situations.