PURPOSE: The attitude of patients after diagnosis of lung cancer is different due to not only TNM stage and cell types but also socio-cultural backgrounds. For the management of lung cancer patients, understanding the backgrounds of their attitude may be important. We studied to know which factors influence on the decision of the treatment modality.
METHODS: We reviewed medical records of 135 patients diagnosed in one tertiary referral center in a year. We used medical chart and questionnaire sheet which we asked when patients refused the treatment recommended by doctor to know why he/she did.
RESULTS: Out of the 135 patients, 57 patients refused or were not recommended conventional treatments. 28 patients were not recommended treatments by doctors except for palliation due to poor performance status. 29 patients refused recommended treatments. 17 out of 29 patients were afraid of side effects of treatments (chemotherapy (CT) in 14, concurrent chemoradiation (CCRT) in 2, operation in 1). Of them 3 patients changed their minds, 2 patients received weekly chemotherapy and 1 patient took gefitinib. 6 out of 29 patients were disappointed in the poor efficacy of the treatments. 3 out of 29 patients accepted the natural course of cancer. 3 out of 29 patients gave up the treatments for the economic problem. 21 out of 29 patients received unconventional treatments (herb medication, dietetic treatment, etc.). Surgical operation, radiation only, CT only, CCRT, and surgery after CT were done in 11, 4, 51, 11, and 4 patients respectively. Their treatment modality was chosen from the results of the pathology, TNM stage, pulmonary function, performance status and other comorbid diseases as widely accepted.
CONCLUSION: Many lung cancer patients are out of conventional management. Fear of the side effects during the treatments and the disappointment in efficacy of the treatments are major factors.
CLINICAL IMPLICATIONS: Improving efficacy and reducing side effects of chemotherapy is necessary for the future treatment.
DISCLOSURE: Choonhee Son, None.