Shi-Yi Wang1, Gabrielle Kelly2, Cary Gross3, Brigid K Killelea4, Sarah Mougalian5, Carolyn Presley5, Liana Fraenkel6, Suzanne B Evans7. 1. Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut; Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Cancer Center and Yale University School of Medicine, New Haven, Connecticut. Electronic address: shiyi.wang@yale.edu. 2. Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut. 3. Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Cancer Center and Yale University School of Medicine, New Haven, Connecticut; Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut. 4. Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Cancer Center and Yale University School of Medicine, New Haven, Connecticut; Department of Surgery, Yale University School of Medicine, New Haven, Connecticut. 5. Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Cancer Center and Yale University School of Medicine, New Haven, Connecticut; Section of Medical Oncology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut. 6. Section of Rheumatology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut. 7. Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale Cancer Center and Yale University School of Medicine, New Haven, Connecticut; Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut.
Abstract
PURPOSE: To identify the information older women with early-stage breast cancer need when making radiation therapy decisions, and who patients identify as the main decision maker. METHODS AND MATERIALS: We surveyed (through face-to-face interview, telephone, or mail) women aged ≥65 years who received lumpectomy and were considering or receiving adjuvant radiation therapy for early-stage breast cancer. The survey instrument was constructed with input from patient and professional advisory committees, including breast cancer survivors, advocates of breast cancer care and aging, clinicians, and researchers. Participants rated the importance (on a 4-point scale) of 24 statements describing the benefits, side effects, impact on daily life, and other issues of radiation therapy in relation to radiation therapy decision making. Participants also designated who was considered the key decision maker. RESULTS: The response rate was 56.4% (93 of 165). Mean age was 72.5 years, ranging from 65 to 93 years. More than 96% of participants indicated they were the main decision maker on receiving radiation therapy. There was wide variation in information needs regarding radiation therapy decision making. Participants rated a mean of 18 (range, 3-24) items as "essential." Participants rated items related to benefits highest, followed by side effects. Participants who were older than 75 years rated 13.9 questions as essential, whereas participants aged ≤74 years rated 18.7 as essential (P=.018). CONCLUSIONS: Older women desire information and have more agency and input in the decision-making process than prior literature would suggest. The variation in information needs indicates that future decision support tools should provide options to select what information would be of interest to the participants.
PURPOSE: To identify the information older women with early-stage breast cancer need when making radiation therapy decisions, and who patients identify as the main decision maker. METHODS AND MATERIALS: We surveyed (through face-to-face interview, telephone, or mail) women aged ≥65 years who received lumpectomy and were considering or receiving adjuvant radiation therapy for early-stage breast cancer. The survey instrument was constructed with input from patient and professional advisory committees, including breast cancer survivors, advocates of breast cancer care and aging, clinicians, and researchers. Participants rated the importance (on a 4-point scale) of 24 statements describing the benefits, side effects, impact on daily life, and other issues of radiation therapy in relation to radiation therapy decision making. Participants also designated who was considered the key decision maker. RESULTS: The response rate was 56.4% (93 of 165). Mean age was 72.5 years, ranging from 65 to 93 years. More than 96% of participants indicated they were the main decision maker on receiving radiation therapy. There was wide variation in information needs regarding radiation therapy decision making. Participants rated a mean of 18 (range, 3-24) items as "essential." Participants rated items related to benefits highest, followed by side effects. Participants who were older than 75 years rated 13.9 questions as essential, whereas participants aged ≤74 years rated 18.7 as essential (P=.018). CONCLUSIONS: Older women desire information and have more agency and input in the decision-making process than prior literature would suggest. The variation in information needs indicates that future decision support tools should provide options to select what information would be of interest to the participants.
Authors: D Feldman-Stewart; M D Brundage; C Hayter; P Groome; J C Nickel; H Downes; W J Mackillop Journal: Med Decis Making Date: 2000 Jan-Mar Impact factor: 2.583
Authors: Giovanna Gagliardi; Louis S Constine; Vitali Moiseenko; Candace Correa; Lori J Pierce; Aaron M Allen; Lawrence B Marks Journal: Int J Radiat Oncol Biol Phys Date: 2010-03-01 Impact factor: 7.038
Authors: Ian H Kunkler; Linda J Williams; Wilma J L Jack; David A Cameron; J Michael Dixon Journal: Lancet Oncol Date: 2015-01-28 Impact factor: 41.316
Authors: Pamela R Soulos; James B Yu; Kenneth B Roberts; Ann C Raldow; Jeph Herrin; Jessica B Long; Cary P Gross Journal: J Clin Oncol Date: 2012-03-05 Impact factor: 44.544
Authors: Kerry A Sherman; Laura-Kate E Shaw; Caleb J Winch; Diana Harcourt; John Boyages; Linda D Cameron; Paul Brown; Thomas Lam; Elisabeth Elder; James French; Andrew Spillane Journal: Plast Reconstr Surg Date: 2016-10 Impact factor: 4.730
Authors: Kevin S Hughes; Lauren A Schnaper; Donald Berry; Constance Cirrincione; Beryl McCormick; Brenda Shank; Judith Wheeler; Lorraine A Champion; Thomas J Smith; Barbara L Smith; Charles Shapiro; Hyman B Muss; Eric Winer; Clifford Hudis; William Wood; David Sugarbaker; I Craig Henderson; Larry Norton Journal: N Engl J Med Date: 2004-09-02 Impact factor: 91.245
Authors: S Darby; P McGale; C Correa; C Taylor; R Arriagada; M Clarke; D Cutter; C Davies; M Ewertz; J Godwin; R Gray; L Pierce; T Whelan; Y Wang; R Peto Journal: Lancet Date: 2011-10-19 Impact factor: 79.321
Authors: Peter Rüesch; René Schaffert; Susanne Fischer; Deb Feldman-Stewart; Robin Ruszat; Peter Spörri; Markus Zurkirchen; Hans-Peter Schmid Journal: Support Care Cancer Date: 2013-11-28 Impact factor: 3.603
Authors: Betty Hsiao; Pauline Binder-Finnema; W Benjamin Nowell; George Michel; Carole Wiedmeyer; Liana Fraenkel Journal: Arthritis Care Res (Hoboken) Date: 2019-04-08 Impact factor: 4.794
Authors: Benjamin D Smith; Xiudong Lei; Kevin Diao; Ying Xu; Yu Shen; Grace L Smith; Sharon H Giordano; Sarah M DeSnyder; Kelly K Hunt; Mediget Teshome; Reshma Jagsi; Simona F Shaitelman; Susan K Peterson; Cameron W Swanick Journal: Ann Surg Oncol Date: 2020-01-08 Impact factor: 5.344
Authors: Yasamin Sharifzadeh; Alexander N Slade; Elisabeth Weiss; Arnethea L Sutton; Vanessa B Sheppard Journal: J Cancer Educ Date: 2021-06 Impact factor: 2.037
Authors: Alice Zamagni; Milly Buwenge; Ilario Ammendolia; Martina Ferioli; Anna Mandrioli; Alessio G Morganti; Silvia Cammelli Journal: Transl Cancer Res Date: 2020-01 Impact factor: 1.241