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New Research Demonstrates Advances in Optimizing Treatments and Quality of Life for People With Hard-To-Treat Forms of Blood Cancer
Date:12/5/2009

re planning (ACP) provides patients with the opportunity to communicate with their family and health-care provider about their end-of-life choices. Patients who participate in ACP usually have a living will and a health-care proxy, a person who carries out their health-care choices in the event that they become incapable of making medical decisions. However, according to previous studies, only 50 percent of patients with blood cancers who are undergoing a high-risk procedure, such as a stem cell transplant, participate in ACP. Moreover, the group that lacked ACP had a higher mortality rate, suggesting that the group least likely to have ACP is the group most in need of it. While there is a need to increase engagement in ACP, many argue that discussing possible death with patients adds to their stress level. Researchers from the University of Nebraska Medical Center in Omaha and Fred Hutchinson Cancer Research Center in Seattle compared the psychological well-being of patients with blood cancers who did or did not have ACP to help understand how best to design interventions that may increase patient engagement in ACP.

This study analyzed data from the HEMA-COMM (Hematology Communications) study cohort, an observational study that evaluated doctor-patient communication. The study included 293 patients with blood cancers who have ACP - that is, have a designated health-care proxy and a living will - or who did not have ACP - that is, they lacked a health-care proxy or a living will, or both. The two groups were compared according to socio-demographic characteristics, diagnosis, previous treatments, patient and physician estimates of cure and life expectancy, discussions of wishes for life support, and various measures of psychosocial well-being including coping, depression/anxiety, denial, social support, and quality of life.

The study found that both patients who engage and who do not engage in ACP have similar psychosocial well-being except for
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SOURCE American Society of Hematology
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