Table 3.

Additional illustrative quotes by theme

1. Discussion of both harms and benefits

“I feel maybe that there should have been a little bit more time, you know, and a little bit more detail specifically about, what the benefits would be to [taking ACT]… it’s need-to- know information. So, in the decision-making process, there was a specific amount of information that I had to go in there and actually look up for myself.” (Female, age 26, ACT)

“[The doctor] explained some of the side effects that I would have if I needed treatment…nausea, he said I would feel tired. It is not pretty, it is not fun. Those are the words that I remember pretty good.” (Male, age 43, no ACT)

“They informed me about the benefits of chemotherapy, to eliminate malignant cells that had remained in the body, to prevent recurrence if they were not there. And the damage, apart from side effects I was told I would feel, and I’ve felt them, [but was] not [told] anything else. Just [the side effects of ACT].” (Male, age 77, ACT)

2. Patient perceptions of personal risk and clinical benefit

“[The doctor] was clear that, there is no guarantee but I would probably gain a couple of percentage points… you know, having the chemotherapy.” (Female, age 61, ACT)

“He showed me what my, what the statistics were and I had to make up my mind, whether I wanted to go through [ACT] or not…My percentage of living was better with the treatment.” (Female, age 83, ACT)

“The difference between the two percentages, if I had the treatment or not have the treatment with regard to [reoccurrence] was so low that they decided treatment would be more damaging to my body.” (Female, age 53, no ACT)

“I was wanting statistics, if I [took ACT], what would it do to my survival statistics and my statistics of the cancer returning.” (Female, age 61, ACT)

“If it was something like 20% better chance with chemo we would have gone for it. But the fact it was only 5% why go through chemo?” (Male, age 76, no ACT)

3. Patient involvement and preferences for decisional support

“I think medical decisions are hard because doctors give their opinions but you have to put your brain power into them. [The provider was] really recommending [ACT]. She let me know how she felt, [but] I had the option to opt out and it was very confusing.” (Female, age 61, ACT)

“I didn’t really have too much of information as far as like forms of treatments or alternative treatments and things like that…[but the doctor] explained everything and I thought [no ACT] was okay for me.” (Male, age 43, no ACT)

“I didn’t know of multiple [treatment] options I just knew that the chemotherapy was going to be given to me and I didn’t hear of any other options…..I was more or less told that you know, this is what has to be done.” (Female, age 68, ACT)

4. Influence of provider recommendation amidst uncertainty

“I felt that he was an expert and a professional and he knew what he was talking about. I was in an extremely vulnerable position and I put my trust in him….It’s cancer and you don’t want to take any chances” (Female, age 67, ACT).

“The fact that he was so certain, that I needed chemotherapy, was what kept me from opting out.” (Female, age 61, ACT).

“I think I had ultimately a high degree of trust in the oncologist and he has been around a long time, he knew what he was doing.” (Male, age 52, ACT)

“Walking into those offices I thought it was critical that someone well versed in the field examine me…and give me their opinion [on treatment].” (Female, age 52, no ACT)

“[ACT] wasn’t recommended….I mean, why would I get it, if he’s not recommending it?” (Female, age 50, no ACT)