Highlights

Four key factors influence cancer patients’ decisions to participate in Phase I clinical trials.

Why this item may be useful

Participation in Phase I trials is an important decision that influences quality of life for patients with end-stage cancer. The authors identified four phases of the decision-making process and four factors that influence decisions. The core category that explained the decision-making process was searching for a way to live to the end of life. The findings of this study may help nurses and physicians support patients in their decision making.

Details

• This is one of the first studies to explore the process of decision making for advanced cancer patients considering participation in a Phase I trial. Twenty-five end-stage cancer patients in a Japanese cancer center were observed and interviewed as they considered participation in a Phase I clinical trial. Twenty-one patients agreed to participate.
• Four phases of decision-making emerged: (1) waiting for death to come if nothing else is done; (2) assessing the value of the Phase I trial; (3) finding decisive factors; and (4) reminding oneself that this is the right decision.
• The decision-making process was influenced by: (1) patients’ perceptions of physicians’ explanations of the Phase I trial; (2) patients’ perceptions of their families’ attitudes toward the trial; (3) patients’ experiences with past cancer therapies; and (4) patients’ attitudes toward living with cancer.