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To Treat or Not to Treat? Dilemmas when Deciding on Antineoplastic Treatment in Patients With Far Advanced Cancers

Patients with advanced cancers and their oncologists are often faced with difficult treatment decisions, especially when there are borderline situations of expected benefit or increased risk of complications. In this narrative review, we will explore the decision-making process for patients with adv...

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Autores principales: Paiva, Carlos Eduardo, Preto, Daniel D’Almeida, de Lima, Crislaine, Paiva, Bianca Sakamoto Ribeiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10184254/
https://www.ncbi.nlm.nih.gov/pubmed/37178323
http://dx.doi.org/10.1177/10732748231176639
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author Paiva, Carlos Eduardo
Preto, Daniel D’Almeida
de Lima, Crislaine
Paiva, Bianca Sakamoto Ribeiro
author_facet Paiva, Carlos Eduardo
Preto, Daniel D’Almeida
de Lima, Crislaine
Paiva, Bianca Sakamoto Ribeiro
author_sort Paiva, Carlos Eduardo
collection PubMed
description Patients with advanced cancers and their oncologists are often faced with difficult treatment decisions, especially when there are borderline situations of expected benefit or increased risk of complications. In this narrative review, we will explore the decision-making process for patients with advanced cancers and provide insights on how to approach this complex task, while didactically dividing the oncologist’s assessments according to a mnemonic rule of the ABCDE of therapeutic decision-making. Part A (advanced cancer) recalls that the rule is to be used specifically for advanced cancers. Parts B (potential benefits) and C (clinical conditions and risks) represents the traditional risk vs benefit scale. In Part D, we discuss ways to identify and understand patients’ desires, values, preferences, and beliefs. The prognostic estimation, from Part E, may function as an “adjust” for the antineoplastic treatment decision-making. Treatment decisions need to be conducted by skilled oncologists, in a patient-centered care, aiming to promote valuable oncology with lower rates of aggressive care.
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spelling pubmed-101842542023-05-16 To Treat or Not to Treat? Dilemmas when Deciding on Antineoplastic Treatment in Patients With Far Advanced Cancers Paiva, Carlos Eduardo Preto, Daniel D’Almeida de Lima, Crislaine Paiva, Bianca Sakamoto Ribeiro Cancer Control Review Patients with advanced cancers and their oncologists are often faced with difficult treatment decisions, especially when there are borderline situations of expected benefit or increased risk of complications. In this narrative review, we will explore the decision-making process for patients with advanced cancers and provide insights on how to approach this complex task, while didactically dividing the oncologist’s assessments according to a mnemonic rule of the ABCDE of therapeutic decision-making. Part A (advanced cancer) recalls that the rule is to be used specifically for advanced cancers. Parts B (potential benefits) and C (clinical conditions and risks) represents the traditional risk vs benefit scale. In Part D, we discuss ways to identify and understand patients’ desires, values, preferences, and beliefs. The prognostic estimation, from Part E, may function as an “adjust” for the antineoplastic treatment decision-making. Treatment decisions need to be conducted by skilled oncologists, in a patient-centered care, aiming to promote valuable oncology with lower rates of aggressive care. SAGE Publications 2023-05-13 /pmc/articles/PMC10184254/ /pubmed/37178323 http://dx.doi.org/10.1177/10732748231176639 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Paiva, Carlos Eduardo
Preto, Daniel D’Almeida
de Lima, Crislaine
Paiva, Bianca Sakamoto Ribeiro
To Treat or Not to Treat? Dilemmas when Deciding on Antineoplastic Treatment in Patients With Far Advanced Cancers
title To Treat or Not to Treat? Dilemmas when Deciding on Antineoplastic Treatment in Patients With Far Advanced Cancers
title_full To Treat or Not to Treat? Dilemmas when Deciding on Antineoplastic Treatment in Patients With Far Advanced Cancers
title_fullStr To Treat or Not to Treat? Dilemmas when Deciding on Antineoplastic Treatment in Patients With Far Advanced Cancers
title_full_unstemmed To Treat or Not to Treat? Dilemmas when Deciding on Antineoplastic Treatment in Patients With Far Advanced Cancers
title_short To Treat or Not to Treat? Dilemmas when Deciding on Antineoplastic Treatment in Patients With Far Advanced Cancers
title_sort to treat or not to treat? dilemmas when deciding on antineoplastic treatment in patients with far advanced cancers
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10184254/
https://www.ncbi.nlm.nih.gov/pubmed/37178323
http://dx.doi.org/10.1177/10732748231176639
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