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British Journal of Cancer logoLink to British Journal of Cancer
. 1991 Aug;64(2):391–395. doi: 10.1038/bjc.1991.315

Oncologists vary in their willingness to undertake anti-cancer therapies.

S E Lind 1, M J DelVecchio Good 1, C S Minkovitz 1, B J Good 1
PMCID: PMC1977523  PMID: 1892772

Abstract

Previous studies have shown that groups of cancer sub-specialists differ in their stated willingness to undergo treatment for diseases lying within their area of expertise. In order to learn whether oncologists feel similarly about other forms of cancer, medical, radiation, and surgical oncologists were asked to fill out a questionnaire indicating whether they would be willing to undergo either chemotherapy or radiation therapy for a variety of common malignancies, or recommend them to a spouse or sibling. Subjects were also asked whether they would undertake an experimental therapy (interleukin-2) for any of three malignancies, or recommend such treatment to a spouse or relative. Fifty-one oncologists (14 radiation oncologists, 14 surgical oncologists, and 23 medical oncologists) were recruited from the staff of four university teaching hospitals. Although they agreed about accepting or declining therapy for some examples, there was considerable heterogeneity in their responses. In only 37% of the 30 cases involving standard therapies did greater than or equal to 85% of the oncologists agree that they would accept or refuse therapy. Only some of the variation of the responses could be attributed to the sub-specialty orientation of the oncologists. Physicians were as willing to recommend standard therapies for themselves as a spouse or sibling. Physicians were also divided in their opinion about whether they would accept a particular experimental therapy if diagnosed with one of three neoplasms. They were significantly more likely, however, to recommend it for a spouse or sibling than to accept it for themselves. Variation in the proportion of patients who receive anti-cancer therapies may relate, in part, to differences in opinion concerning the worth of such therapies among oncologists or primary physicians. This study shows that oncologists are quite heterogeneous with regard to their personal preferences for anti-cancer treatments for a variety of malignancies. Further studies are required to learn if such attitudes (among oncologists or primary physicians) directly affect the administration of such therapies.

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Selected References

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  1. Argyle J. C., Benjamin D. R., Lampkin B., Hammond D. Acute nonlymphocytic leukemias of childhood. Inter-observer variability and problems in the use of the FAB classification. Cancer. 1989 Jan 15;63(2):295–301. doi: 10.1002/1097-0142(19890115)63:2<295::aid-cncr2820630215>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  2. Bunker J. P., Brown B. W., Jr The physician-patient as an informed consumer of surgical services. N Engl J Med. 1974 May 9;290(19):1051–1055. doi: 10.1056/NEJM197405092901905. [DOI] [PubMed] [Google Scholar]
  3. Freedman B. Equipoise and the ethics of clinical research. N Engl J Med. 1987 Jul 16;317(3):141–145. doi: 10.1056/NEJM198707163170304. [DOI] [PubMed] [Google Scholar]
  4. Greenberg E. R., Chute C. G., Stukel T., Baron J. A., Freeman D. H., Yates J., Korson R. Social and economic factors in the choice of lung cancer treatment. A population-based study in two rural states. N Engl J Med. 1988 Mar 10;318(10):612–617. doi: 10.1056/NEJM198803103181006. [DOI] [PubMed] [Google Scholar]
  5. Greenfield S., Blanco D. M., Elashoff R. M., Ganz P. A. Patterns of care related to age of breast cancer patients. JAMA. 1987 May 22;257(20):2766–2770. [PubMed] [Google Scholar]
  6. Grover S. A., Cook E. F., Adam J., Coupal L., Goldman L. Delayed diagnosis of gynecologic tumors in elderly women: relation to national medical practice patterns. Am J Med. 1989 Feb;86(2):151–157. doi: 10.1016/0002-9343(89)90260-x. [DOI] [PubMed] [Google Scholar]
  7. Hunter C. P., Frelick R. W., Feldman A. R., Bavier A. R., Dunlap W. H., Ford L., Henson D., Macfarlane D., Smart C. R., Yancik R. Selection factors in clinical trials: results from the Community Clinical Oncology Program Physician's Patient Log. Cancer Treat Rep. 1987 Jun;71(6):559–565. [PubMed] [Google Scholar]
  8. Kong A., Barnett G. O., Mosteller F., Youtz C. How medical professionals evaluate expressions of probability. N Engl J Med. 1986 Sep 18;315(12):740–744. doi: 10.1056/NEJM198609183151206. [DOI] [PubMed] [Google Scholar]
  9. Lotze M. T., Chang A. E., Seipp C. A., Simpson C., Vetto J. T., Rosenberg S. A. High-dose recombinant interleukin 2 in the treatment of patients with disseminated cancer. Responses, treatment-related morbidity, and histologic findings. JAMA. 1986 Dec 12;256(22):3117–3124. [PubMed] [Google Scholar]
  10. Mackillop W. J., O'Sullivan B., Ward G. K. Non-small cell lung cancer: how oncologists want to be treated. Int J Radiat Oncol Biol Phys. 1987 Jun;13(6):929–934. doi: 10.1016/0360-3016(87)90109-x. [DOI] [PubMed] [Google Scholar]
  11. Moore M. J., O'Sullivan B., Tannock I. F. How expert physicians would wish to be treated if they had genitourinary cancer. J Clin Oncol. 1988 Nov;6(11):1736–1745. doi: 10.1200/JCO.1988.6.11.1736. [DOI] [PubMed] [Google Scholar]
  12. Mor V., Masterson-Allen S., Goldberg R. J., Cummings F. J., Glicksman A. S., Fretwell M. D. Relationship between age at diagnosis and treatments received by cancer patients. J Am Geriatr Soc. 1985 Sep;33(9):585–589. doi: 10.1111/j.1532-5415.1985.tb06313.x. [DOI] [PubMed] [Google Scholar]
  13. Samet J., Hunt W. C., Key C., Humble C. G., Goodwin J. S. Choice of cancer therapy varies with age of patient. JAMA. 1986 Jun 27;255(24):3385–3390. [PubMed] [Google Scholar]
  14. Taylor K. M., Margolese R. G., Soskolne C. L. Physicians' reasons for not entering eligible patients in a randomized clinical trial of surgery for breast cancer. N Engl J Med. 1984 May 24;310(21):1363–1367. doi: 10.1056/NEJM198405243102106. [DOI] [PubMed] [Google Scholar]
  15. Wennberg J. E., Mulley A. G., Jr, Hanley D., Timothy R. P., Fowler F. J., Jr, Roos N. P., Barry M. J., McPherson K., Greenberg E. R., Soule D. An assessment of prostatectomy for benign urinary tract obstruction. Geographic variations and the evaluation of medical care outcomes. JAMA. 1988 May 27;259(20):3027–3030. [PubMed] [Google Scholar]
  16. Wennberg J. Which rate is right? N Engl J Med. 1986 Jan 30;314(5):310–311. doi: 10.1056/NEJM198601303140509. [DOI] [PubMed] [Google Scholar]

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