Living with advanced cancer and an uncertain disease trajectory: An emerging patient population in palliative care?

Lobb, EA; Lacey, J; Kearsley, J; Liauw, W; White, L; Hosie, A

Living with advanced cancer and an uncertain disease trajectory: An emerging patient population in palliative care?

Lobb, EA Lacey, J Kearsley, J Liauw, W White, L Hosie, A

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Publication Type:: Journal Article
Citation:: BMJ Supportive and Palliative Care, 2015, 5 (4), pp. 352 - 357
Issue Date:: 2015-01-01

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Field	Value	Language
dc.contributor.author	Lobb, EA	en_US
dc.contributor.author	Lacey, J	en_US
dc.contributor.author	Kearsley, J	en_US
dc.contributor.author	Liauw, W	en_US
dc.contributor.author	White, L	en_US
dc.contributor.author	Hosie, A https://orcid.org/0000-0003-1674-2124	en_US
dc.date.available	2012-12-16	en_US
dc.date.issued	2015-01-01	en_US
dc.identifier.citation	BMJ Supportive and Palliative Care, 2015, 5 (4), pp. 352 - 357	en_US
dc.identifier.issn	2045-435X	en_US
dc.identifier.uri	http://hdl.handle.net/10453/116135
dc.description.abstract	Objective This study explored how patients diagnosed with advanced cancer cope with an uncertain disease trajectory. Subjects 27 patients with advanced cancer and with a prognosis of 12 months or more were recruited from the medical/radiation oncology and palliative care service at three metropolitan hospitals. Methods A semistructured face-to-face interview was conducted. Interviews were audiotaped and transcribed verbatim. Data analysis was based on Grounded Theory using the constant comparison method. Results Results indicate that patients cope by avoidance, remaining positive, maintaining as normal a life as possible, minimising the impact of the disease on their daily lives, comparing themselves favourably with others in a similar situation and focusing on the outcome of treatment to control disease progression. Most did not wish to discuss prognosis or have detailed information on disease progression. Conclusions Participants in this study represent an emerging cancer patient population who are receiving palliative therapies. While they have incurable cancer, they self-report as clinically well, they describe a good quality of life and the trajectory of their disease, while unpredictable, may extend over many months to years. Our study suggests that a flexible model of care is needed to support the needs of people who may still be receiving some form of chemotherapy and/or radiotherapy, and remain well. This model may need to take more of an intermittent approach, that is, as required for specific symptom management, rather than patients being linked continuously to a palliative care service for long periods of time.	en_US
dc.relation.ispartof	BMJ Supportive and Palliative Care	en_US
dc.relation.isbasedon	10.1136/bmjspcare-2012-000381	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Neoplasms	en_US
dc.subject.mesh	Disease Progression	en_US
dc.subject.mesh	Palliative Care	en_US
dc.subject.mesh	Adaptation, Psychological	en_US
dc.subject.mesh	Quality of Life	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Aged, 80 and over	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Young Adult	en_US
dc.title	Living with advanced cancer and an uncertain disease trajectory: An emerging patient population in palliative care?	en_US
dc.type	Journal Article
utslib.citation.volume	4	en_US
utslib.citation.volume	5	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1110 Nursing	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access
pubs.issue	4	en_US
pubs.publication-status	Published	en_US
pubs.volume	5	en_US

Abstract:

Objective This study explored how patients diagnosed with advanced cancer cope with an uncertain disease trajectory. Subjects 27 patients with advanced cancer and with a prognosis of 12 months or more were recruited from the medical/radiation oncology and palliative care service at three metropolitan hospitals. Methods A semistructured face-to-face interview was conducted. Interviews were audiotaped and transcribed verbatim. Data analysis was based on Grounded Theory using the constant comparison method. Results Results indicate that patients cope by avoidance, remaining positive, maintaining as normal a life as possible, minimising the impact of the disease on their daily lives, comparing themselves favourably with others in a similar situation and focusing on the outcome of treatment to control disease progression. Most did not wish to discuss prognosis or have detailed information on disease progression. Conclusions Participants in this study represent an emerging cancer patient population who are receiving palliative therapies. While they have incurable cancer, they self-report as clinically well, they describe a good quality of life and the trajectory of their disease, while unpredictable, may extend over many months to years. Our study suggests that a flexible model of care is needed to support the needs of people who may still be receiving some form of chemotherapy and/or radiotherapy, and remain well. This model may need to take more of an intermittent approach, that is, as required for specific symptom management, rather than patients being linked continuously to a palliative care service for long periods of time.

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http://hdl.handle.net/10453/116135