Patients’ voices in a treatment matter. Since going through cancer treatment is a long and difficult journey, it is important that both the patient and the doctor move along the path in partnership. Shared decision-making in the treatment process and assessing the progress of treatment involving patient’s perspectives become important. A new study finds that a breast cancer patient’s perspective on their physical well-being can provide a better indication of their response to cancer treatment than clinician-based tools. The research also identified differences between clinician-based data and patient-reported data, with some clinicians overestimating their patient’s physical well-being.

“An essential component of patient-centered care, shared decision making is a process in which the clinician and patient collate and discuss the available evidence on the benefits and harms of treatments, ensuring the most appropriate and informed decision is made for the patient,” says study lead author Natansh Modi, an NHMRC PhD candidate in the Clinical Cancer Epidemiology Lab at Flinders University.

Patient’s perspective on their physical, social, emotional, and functional abilities

The Eastern Cooperative Oncology Group performance status (ECOG PS) — which is interpreted by the physician, and patient-reported outcomes (PROs) — are structured instruments that allow a patient to self-report their perspective on their functional, social, emotional, and physical abilities, are two tools that can be used during shared decision making.

“PROs are generally used as secondary data in clinical trials to help with interpreting results; however, they have recently shown to be important in providing a prognosis to the patient for cancer types including bladder, lung, and skin cancers, but their value to HER2-positive advanced breast cancer had yet to be fully explored,” says Modi.

The study, which was published in the journal ESMO Open, combined data from many trials to examine over 3000 patients who received medication therapy for breast cancer that was positive for the human epidermal growth factor receptor 2 (HER2).

Patients better able to predict overall prognosis than the clinician

“We found that a number of patient-reported outcomes, including those on physical well-being and mental health, were identified as significant factors associated with either the patient’s overall survival of cancer, with cancer not progressing or severe adverse events during treatment,” says Modi.

“The results indicate that information provided by the patients themselves was better able to predict their reaction to the treatment and their overall prognosis than the clinician-interpreted scores. Significantly, patient-reported physical well-being was found to be the most useful patient-reported outcome in determining a diagnosis for all available treatment outcomes,” he adds.

The study discovered that the patient-reported data and the clinician-based data occasionally produced drastically divergent findings.

Importance of listening to patients

“We determined that around 70% of the patients who their clinicians defined as ‘fully active, and able to carry on all pre-disease performance without restrictions’ went on to report limitations in their physical well-being status when asked to self-report,” says Modi.

According to the authors, the study emphasises the need of patient listening, and both kinds of tools offer useful, independent prognostic data.

“This study demonstrates that patient-reported physical well-being can predict prognosis better than clinician-interpreted ECOG PS. It is, therefore, essential that clinical practice transforms to place a greater emphasis on the patient’s perspective and voice,” says Mr Modi.

“By combining patient-reported questionnaires and clinically interpreted measures, we can provide the best clinical insights that allow for shared decision-making in cancer treatment, while also enhancing the design of future clinical trials.”

Story Source:

Materials provided by Flinders University. Note: Content may be edited for style and length.

Journal Reference:

N.D. Modi, N.O. Danell, R.N.A. Perry, A.Y. Abuhelwa, A. Rathod, S. Badaoui, R.A. McKinnon, M. Haseloff, A. Shahnam, S.M. Swain, M. Welslau, M.J. Sorich, A.M. Hopkins. Patient-reported outcomes predict survival and adverse events following anticancer treatment initiation in advanced HER2-positive breast cancer. ESMO Open, 2022; 7 (3): 100475 DOI: 10.1016/j.esmoop.2022.100475

Page citation:

Flinders University. “Patient voices a good predictor of cancer treatment outcomes.” ScienceDaily. ScienceDaily, 24 May 2022. <www.sciencedaily.com/releases/2022/05/220524110705.htm>.

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