Patients with advanced cancer changed their attitudes regarding striving for quality of life (QL) and/or length of life (LL) throughout the course of their cancer care; therefore, oncology clinicians should discuss goals-of-care repeatedly. These findings were published in JCO Oncology Practice.

The literature on this subject is scarce; therefore, a team of researchers in the Netherlands conducted a secondary analysis of the randomized controlled CHOICE trial to explore patients’ attitudes about striving for QL and/or LL, whether those attitudes change during the trajectory of cancer treatment, and what may prompt those changes in attitude.

“Learning whether these attitudes change over time is relevant, as decision making about advanced cancer care is rarely one-off, particularly given the upsurge in treatment options,” the researchers wrote.

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The data analyzed was from 173 patients with advanced cancer whose life expectancy without anticancer treatment was 12 or fewer months, and median survival benefits of systemic therapy was less than 6 months. The researchers assessed patients’ attitudes toward striving for QL and/or LL with 4-item subscales from the Quality Quantity Questionnaire shortly after the consultation and at the 3- and 6-month mark.

“On average, patients reported more positive attitudes toward striving for QL compared with LL,” the researchers wrote, but they went on to note, “We found that, on average, patients’ attitudes toward striving for QL became somewhat less positive over 6 months.”

The patients’ attitudes toward striving for LL didn’t change on a group level. However, the researchers noted that the study didn’t account for the patients’ experiences with treatments or changes in their personal circumstances that might have played a role.

Ultimately, these findings can be useful in informing clinicians about the importance of having repeated goals-of-care conversations with their patients. Oncology healthcare professionals, including nurses, can support patients in shared decision making by discussing patients’ goals, coping styles, and emotions throughout the progression of their illness and helping them actualize the goals that are best for them.

Disclosures: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


van der Velden NCA, van Laarhoven HWM, Nieuwkerk PT, et al. Attitudes toward striving for quality and length of life among patients with advanced cancer and a poor prognosis. JCO Oncol Pract. Published online October 6, 2022. doi:10.1200/OP.22.00185

This article originally appeared on Oncology Nurse Advisor