Patient Priorities in Decision Making for Laryngeal Cancer Treatment

Abstract

Objectives:

(1) Ascertain the priorities of laryngeal cancer patients concerning oncologic and functional outcomes. (2) Describe how these priorities and professional referral patterns might influence treatment-related decision making.

Methods:

This cross-sectional survey-based pilot study explored patient preferences and priorities regarding treatment-related decision making for laryngeal cancer using a validated survey instrument. Other questions assessed patient priorities concerning the desired outcomes of their laryngeal cancer treatment and how professional referral patterns (ie, order in which they are seen by different specialists) and desired provider input affect their decisions. Adults with biopsy-proven laryngeal carcinoma were eligible to participate (n = 57; 46% treated surgically, 54% treated nonsurgically).

Results:

The 4 most important priorities for patients with laryngeal cancer are oncologic cure (91%), maximizing survival (66%), being able to swallow (44%), and maintenance of natural voice (41%). When considering the level of involvement of surgeons, radiation oncologists, and medical oncologists in their care, patients thought that the specialist who they saw first was most involved in deciding how to treat their cancer (Fisher’s exact, ~χ²(6) = 14.2, P = .01). Similarly, patients were more likely to believe the specialist who they saw first was the most important factor in deciding how to treat their cancer (Fisher’s exact, ~χ²(6) = 16.2, P = .02).

Conclusions:

Patient priorities and attitudes coupled with professional referral patterns influence how patients contemplate choices regarding management of their laryngeal cancer. Better understanding of these variables may assist in ensuring that patients’ voices are integrated into individualized laryngeal cancer treatment planning.