loading page

Escalation, maintenance and abstention in oncology A new study design to identify how individual values of patients impact on the assessment of risks and benefits of novel therapeutic concepts in cases of gynaecological tumors and colorectal cancer: A study protocol
  • +5
  • Theis S,
  • Senyigit J,
  • Büchler B,
  • Diederichsen K,
  • Kolck G,
  • Möhler M,
  • * Hasenburg,
  • Paul NW
Theis S
University Medical Center of Johannes Gutenberg University Mainz

Corresponding Author:[email protected]

Author Profile
Senyigit J
Johannes Gutenberg University Medical Center Mainz
Author Profile
Büchler B
Johannes Gutenberg University Medical Center Mainz
Author Profile
Diederichsen K
University Medical Center of Johannes Gutenberg University Mainz
Author Profile
Kolck G
University Medical Center of Johannes Gutenberg University Mainz
Author Profile
Möhler M
University Medical Center of Johannes Gutenberg University Mainz
Author Profile
* Hasenburg
University Medical Center of Johannes Gutenberg University Mainz
Author Profile
Paul NW
Johannes Gutenberg University Medical Center Mainz
Author Profile

Abstract

Being diagnosed with cancer is a pivotal moment in a person’s life and changes biographies fundamentally, especially in terms of temporality and physicality. Modern concepts of maintenance therapy or therapeutic abstinence are at odds with typical desire of patients to fight the disease radically. Decisions about therapeutic goals are caught between medical-scientific expertise on the one hand and life-world judgements and values on the other. This makes it particularly challenging to reconcile different preferences and norms. This study aims to analyse values in the context of the challenging human experience of cancer. We hypothesise that established quantitative measures and even more patient-centred assessment tools such as PROMs may not be adequate to capture therapeutic success as understood by patients. Semi-structured interviews will be carried out with participants with gynaecological or colorectal cancer. We propose a mixed methods approach to identify participants’ values, individual treatment goals, and expectations. Outcomes of the study are defined as: 1) ethical analysis of values in the context of human experiences with cancer 2) reconstruction of values triggering individual treatment goals and positive and negative expectations 3) comparison of ethical concepts of successful life with situational values of patients with evidence-based (medical-scientific) preferences. This results in following secondary objectives: 1) Establishing a strategy for patient-centred adaptation of clinical evaluation of therapeutic concepts of escalation, maintenance or abstinence, 2) modelling of a well operationalised clinical strategy for therapeutic goal setting, 3) teaching this strategy, including the clinical oncological, ethical and communicative requirements, as part of medical education.