The researchers asked oncologists about several scenarios involving treatment choices that produced differences in quality of life and length of life, and for the most part, doctors came out as valuing an increase of length. Which isn't surprising; what doctor would routinely say to a patient, "I could give you five years, but I'm going to recommend three really happy months"? For that matter, what patient, when faced with the choice -- at least at initial treatment decision -- won't take more time?
Of course, part of the problem with the study is that they never really define "quality of life," at least not in the report they provide of it. What does that mean? Side effects that are horrible, but only temporary (like hair loss or neuropathy)? Or something debilitating, like permanent heart damage that results in a sedentary life? Or something worse?
I would imagine it would depend on a patient's circumstances, too. An 85 year old is obviously going to make different choices than a 30 year old, and one would hope that a doctor would take those factors into consideration.
I guess the real issue here is about communication, as the article's last sentence sums up: "If you ever face an illness forcing you to decide between living long or prospering, make sure it is your values that rule the day, not your doctor’s." The choices are ultimately ours, as patients, not our doctors'. I think I'm fortunate to have an oncologist who values quality of life -- sometimes even more than I do. There have been times when I have suggested a treatment, and it resulted in conversations about its downside, short- and long-term. His philosophy is "Do no harm," and he seems to understand that harm encompasses both the physical and emotional.
Of course, not everyone is so lucky to have an oncologist like mine. And that's where communication comes in -- and maybe a second opinion as well.
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