Patient Decision Making

Abstract

Decision making in older cancer patients involves several aspects. Some are physician-assessed: objective benefits (e.g., response rate, survival), objective risks, amount of co-morbidity and its impact on treatment choices. Others are patient-assessed: value of the benefits compared to the risks, impact of the cancer, and treatment on the life of the patient compared to other illnesses, events, and life values. One should be aware, however, that the physician’s presentation of the options is colored by the physician’s own experience: other patients treated with that regimen, other patients with this disease, “look” of the patient, physician’s a priori guesses about the willingness of the patient to undergo the treatment. The latter is especially difficult, as, with age, cancer patients become increasingly diverse in their health and life experience. Therefore, besides knowing as much data as possible about cancer and its treatment in the elderly, it is important to gain knowledge about what is known concerning the decision making of older cancer patients. Fortunately, a certain amount of data is available.