Discordance Seen Between Care Goals, Treatment Intent in Advanced Cancer
MONDAY, Aug. 25, 2025 -- More patients with advanced cancer report that their treatment discordantly focuses on longevity over comfort than patients with other illnesses, according to a study published online Aug. 25 in Cancer.
Manan P. Shah, M.D., from the University of California in Los Angeles, and colleagues conducted a post-hoc cross-sectional analysis of baseline survey responses in adults enrolled in a multisite trial of advance care planning. Patients reported whether they prefer and are receiving treatment that prioritizes longevity (life-extending care) or comfort (comfort-focused care); concordance between care preferences and perceived treatment intent was compared for patients with advanced cancer versus other advanced illnesses.
The analyses included 1,099 patients, including 231 with advanced cancer. The researchers found that compared with patients with other serious illnesses, those with advanced cancer reported a similar preference for comfort-focused care and had similar 24-month mortality. Among patients preferring comfort-focused care, those with cancer were more likely to report receiving life-extended care than patients with other illnesses (37 versus 19 percent). Among patients with cancer who preferred comfort-focused care, no significant difference was seen in 24-month mortality for those who reported receiving discordant versus concordant care (24 versus 15 percent).
"This disconnect between what patients want and what they feel they're getting is an important issue," Shah said in a statement. "One takeaway is that doctors need to have open conversations with patients about their goals, clearly explain the intent of the treatment they are providing, and try to reconcile any real or perceived discordance between goals and treatment."
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