Exploring decision making for treatment in LARC and LRRC: A qualitative study.

Area of Science:

• Oncology
• Surgical Oncology
• Patient-Centered Care

Background:

• Decision-making for rectal cancer has evolved with patient involvement.
• Limited understanding exists regarding decision-making complexities in pelvic exenteration (PE) for rectal cancer.
• This study addresses the need to explore patient and clinician perspectives in PE decision-making.

Purpose of the Study:

• To explore patient and healthcare professional (HCP) perceptions of factors crucial during the decision-making process for pelvic exenteration (PE) in rectal cancer.
• To identify discrepancies between patient and HCP priorities in treatment decisions.
• To inform improved pre-operative counseling and support services.

Main Methods:

• Prospective, cross-sectional, qualitative study design.
• In-depth virtual telephone interviews conducted with patients and HCPs across five UK centers (January-October 2020).
• Thematic content analysis of interview transcripts using NVIVO 12.

Main Results:

• Thirty-three interviews (25 patients, 8 HCPs) were analyzed.
• Six key themes emerged: communication, recovery, psychological impact, relationships, lifestyle, and support.
• HCPs prioritized treatment expectations, recovery, and psychological impact, while patients' priorities were broader.

Conclusions:

• Significant differences exist between patient and HCP priorities in the decision-making process for PE.
• Findings emphasize the need for tailored pre-operative counseling to address individual patient needs.
• A standardized, dedicated service is recommended across the UK to meet patients' informational needs.