FORWARD LOOK | BEYOND THE NEWS
To better understand how patients set
their personal goals, Kevin Rand, a psychologist at Indiana University–Purdue
University Indianapolis, and his colleagues
surveyed 84 patients with incurable cancer
who were estimated to have less than a
year before their tumor progressed or they
died. The patients were asked to write
down their current life goals. Then they
were asked to list their current goals for
cancer treatment. After that, the patients
were presented with both lists and asked
to select up to five top goals.
The study, published in July 2016 in
Supportive Care in Cancer, found the
patients’ top treatment goals were fighting or curing the cancer and living longer.
Their life goals looked a lot like those
of any healthy person. When asked to
choose which goals were most important
to them, the patients put treatment goals
ahead of their life goals.
The researchers concluded that
patients tend to think of treatment goals
as separate from life goals, only rarely
considering the relationship between the
two. This didn’t surprise Larry Cripe, a
hematologist at Indiana University Simon
Cancer Center who worked with Rand
on the study. Cripe says that patients
have a hard time reconciling their life
and treatment goals. As a result, patients
sometimes make treatment decisions that
appear to be at odds with their larger life
goals, such as choosing aggressive treat-
ments that may decrease their quality of
life. Cripe recommends that all patients
have goal-oriented conversations with
their doctors early on, when treatment
options are often relatively straightfor-
ward, to prepare for a time when decisions
become more complex.
William Breitbart, a psychiatrist at
Memorial Sloan Kettering Cancer Center
in New York City, encourages patients to
ask themselves questions such as “What
gives your life meaning? What are your
values? Who are you or who have you
been trying to become your whole life,
and how do you want to approach dying
as the authentic person that you are?”
The answers, he says, can help patients
maintain a sense of purpose in their lives
and choose among treatment options
with those larger life goals in mind.
—KENDALL K. MORGAN
Biomarker Linked to Risk for Chemo-Related
Heart Damage, Study Finds
A genetic analysis of 3,431 breast cancer
patients enrolled in a clinical trial of a
chemotherapy regimen that included the
anthracycline Adriamycin (doxorubicin)
identified a single nucleotide polymorphism
(SNP), rs28714259, associated with an
increased risk of congestive heart failure.
The SNP’s link to an increased risk of
heart problems was confirmed in genetic
analyses of patients enrolled in two other
breast cancer clinical trials studying
anthracyclines. The researchers say
these findings will contribute to efforts to
personalize cancer care.
LEARN MORE IN THE JANUARY 2017
CLINICAL CANCER RESEARCH.
ASK YOUR DOCTOR
To help you match treatment decisions to your
larger life goals, consider asking your doctor:
• What is the goal of this treatment?
• What is the chance this treatment will prolong or
shorten my life?
• How will this treatment affect my quality of life?
• How will this treatment interfere with my ability to
achieve other life goals?
Making Treatment Decisions
PERSONAL GOALS COME INTO PLAY FOR PATIENTS
WITH ADVANCED CANCER
Patients with incurable cancers often face difficult decisions about which treatments to try next or whether to pursue treatment at all. To help weigh options, patients are
often encouraged to reflect on their personal goals. But what goals
do patients with advanced cancer consider most important, and
how should they go about making treatment decisions accordingly?