“Intensive” chemotherapy which bears a noteworthy amount of toxicity with a minor chance of cure and “nonintensive” chemotherapy which would control the illness and only has a few side effects are some of the treatment choices that older patients (less than or equal to 60 years) who are diagnosed with acute myeloid leukemia (AML) have to face and choose from. However, there is a shortage of investigations of how these patients comprehend the dangers and advantages of such medicines. A longitudinal study consisting of older patients who were recently diagnosed with AML was conducted and it evaluated patients’ (n=100) and oncologists’ (n=11) discernment of treatment-related mortality when they first joined and at prognosis after 1 month. By utilizing Cohen’s kappa (κ<0.10 indicates little/no concordance), the researchers analyzed the agreement between the perceptions of the patients and the oncologists.
Within 72 hours of initiating intensive (n=50) or nonintensive (n=50) chemotherapy on patients, the researchers enrolled them. 91% of patients stated that they were “somewhat” to “extremely likely” to not survive from the treatment whilst oncologists estimated that only 12% were at high risk of passing away due to treatment (κ=−0.09). 90% of the patients stated that they were “somewhat” or “very likely” to be cured of their acute myeloid leukemia. However, according to oncologists’ estimation, only 31% of the patients were going to get cured (κ=0.05). 98% of the patients amidst the fifty who received intensive chemotherapy announced that they were “somewhat” or “very likely” to get cured whilst the estimation of their oncologists said that the possibility of cure was only 49% (κ=0.04); the proportion amongst the fifty patients who received nonintensive chemotherapy and their oncologists was 82% and 13% respectively (κ=0.03). Higher symptoms of depression (p=0.03) were detected in the patients who showed a lower possibility of being cured.
The dangers of AML and the advantages of treatment are both overestimated by older patients. It is necessary to communicate with the patients and improve their comprehension regarding the aims of the therapy and treatment risks.
Link:theoncologist.onlinelibrary.wiley.com/doi/10.1634/theoncologist.2018-0317
