Last year in the UK over 60,000 cancer patients enrolled on clinical trials aimed at improving cancer treatments and making them available to all.
A study to find out what patients, their families or carers and health care staff think about chemotherapy for controlling symptoms (ASPECTS)
The aim of this study was to collect information about people’s experiences of having palliative chemotherapy for advanced bowel cancer, non small cell lung cancer or pancreatic cancer.
People with advanced cancer may be offered chemotherapy to help control symptoms or slow the growth of the cancer. This is called ‘palliative’ chemotherapy.
It is often very difficult for people to decide whether to have palliative chemotherapy or not. There are many things to consider. The drugs are likely to have side effects for example. Some people, who may not have very long to live, prefer not to spend their time going to hospital for treatment and having problems with side effects. But others are keen to have treatment if it will help them live a bit longer.
In this study the researchers wanted to find out
- What people with cancer, doctors and nurses thought about palliative chemotherapy
- How specialists talk to people about having palliative chemotherapy
Summary of results
The study team’s main finding was that there is a great variation in what people are told about how much (or how little) palliative chemotherapy is likely to help them.
The study recruited people with advanced pancreatic cancer, non small cell lung cancer and bowel cancer who were going to be asked if they wanted to have palliative chemotherapy. The researchers also spoke to doctors, nurses and carers.
- 45 people with advanced cancer were interviewed before an appointment with their specialist to discuss treatment options
- 39 of these appointments were watched and recorded
- 37 of the people were interviewed at least once in the weeks after the appointment
- 31 carers were interviewed
- 15 doctors and nurses were interviewed
The researchers collected a lot of information on how people make decisions about treatment and their experiences of palliative chemotherapy.
They found that specialists seemed reluctant to tell people in detail that palliative chemotherapy increases the length of time they are likely to live by only a small amount. And not many doctors discussed ‘
Doctors did explain the potential side effects of chemotherapy, but spent much less time talking about the possible benefits of treatment and how limited they may be.
The study team suggest that training for doctors should help them to give this sort of information to patients in a sensitive way, so that people can make decisions about treatment with a full understanding of the potential benefits and drawbacks (informed consent).
We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (
How to join a clinical trial
Professor R Campbell
Cancer Research UK
National Institute for Health Research Cancer Research Network (NCRN)
United Bristol Healthcare NHS Trust
University of Bristol
Weston Area Health Trust