Cancer Treatment Decisions: A Qualitative Study (Version 1)
Research type
Research Study
Full title
Choosing Not to Undergo Cancer Treatment: A Qualitative Study of Lived Experiences That May Have Influenced Treatment Decisions.
IRAS ID
296071
Contact name
Naomi White
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde
Duration of Study in the UK
0 years, 5 months, 30 days
Research summary
Research Summary
Some cancer treatments can significantly impact physical health, emotional wellbeing, relationships, and quality of life. Choosing not to undergo recommended cancer treatments or aspects of treatment such as chemotherapy is a sensitive topic rarely reported within research studies. Clinical psychologists working within oncology settings report that patients refer to their values as having influenced their decision making. Some patients report that living their lives according to their values, e.g., being active and independent, is an important consideration.
The study aims to understand the experiences of cancer patients who choose not to undergo cancer treatment or an aspect of treatment. A further aim is to explore how patients’ values influenced their decision. The study aims to address the following research questions:
1. How do patients describe their experiences of the decision-making process when discussing treatment options with oncology staff?
2. How do patients perceive the role of living in accord with their values during the treatment decision process?
Patients with a cancer diagnosis will be invited to participate in the study. Semi-structured interviews will be conducted at the Beatson West of Scotland Cancer Centre or via video call via Zoom. Interviewing patients who have opted out of treatment or aspects of treatment would establish what role do values have in reaching treatment decisions. The research aims to inform current clinical practice concerning person-centred care and shared decision-making between patients and clinicians. Findings will be shared and used to inform services and future research.
The study is part of a doctoral project at the University of Glasgow, sponsored by NHS Greater Glasgow & Clyde. It is estimated to be completed at the Beatson West of Scotland Cancer Centre within the next twelve months.
Summary of Research
Choosing Not To Undergo Cancer Treatment: A Qualitative Study of Lived Experiences That May Have Influenced Treatment Decisions
Objectives: Declining cancer treatment is a sensitive topic infrequently reported in research. Research suggests that patients make treatment decisions according to their personal values, beliefs, and preferences. The primary aim of the research was to understand individuals’ lived experiences and sense-making of decisions to decline recommended cancer treatment or aspects of treatment. A secondary aim was to explore how decisions reached were influenced by personal values.
Design: Semi-structured interviews with patients with a cancer diagnosis (n= 6; female, 39 – 85 years) who had declined recommended cancer treatment were conducted. Qualitative data was analysed using Reflexive Thematic Analysis.
Results: Three core themes and seven sub-themes described participants' experiences, illustrating perceived barriers to communication and mismatched expectations with Health Care Professionals (HCPs) during treatment decision-making. Participants reported no choice regarding alternative treatments and pathways other than standard treatments. Finally, participants described a wish to live the remainder of their lives engaged in what mattered most to them, free of potential treatment side effects, as influencing their decision to decline cancer treatment.
Conclusions: Perceived communication barriers and implicit bias within healthcare may impede reaching a shared understanding during treatment decision-making. Treatment decision-making aligned with patients’ values, preferences, and beliefs is essential when planning oncology care. Findings support the need for oncology services to consider communication skills and implicit bias training for HCPs alongside the development of a patient decision aid. Declining cancer treatment can be isolating. The development of peer support groups is recommended.
REC name
West of Scotland REC 5
REC reference
21/WS/0129
Date of REC Opinion
27 Oct 2021
REC opinion
Favourable Opinion