Patients with advanced cancer change their attitudes regarding striving for quality of life (QL) and/or length of life (LL) throughout the course of their cancer care, according to a study published in JCO Oncology Practice.

For this study, researchers 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 came from 173 patients with advanced cancer whose life expectancy without anticancer treatment was 1 year or less, and the median survival benefit 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-month and 6-month marks.

“On average, patients reported more positive attitudes toward striving for QL compared with LL,” the researchers wrote. “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, on an individual level, 76% of patients had changes in their attitudes toward striving for QL and/or LL at some point during the study.

According to the researchers, these findings can be useful in informing clinicians about the importance of having repeated goals-of-care conversations with their patients. Oncology healthcare professionals 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