title: Cancer patient preferences for quality and length of life.
abstract: BACKGROUND
  Optimal patient decision making requires integration of patient values, goals, and preferences with information received from the physician. In the case of a life-threatening illness such as cancer, the weights placed on quality of life (QOL) and length of life (LOL) represent critical values. The objective of the current study was to describe cancer patient values regarding QOL and LOL and explore associations with communication preferences.
  
  
  METHODS
  Patients with advanced cancer completed a computer-based survey before the initial consultation with a medical oncologist. Assessments included sociodemographics, physical and mental health state, values regarding quality and length of life, communication preferences, and cancer-related distress.
  
  
  RESULTS
  Among 459 patients with advanced cancer, 55% placed equal valued on QOL and LOL, 27% preferred QOL, and 18% preferred LOL. Patients with a QOL preference had lower levels of cancer-related distress (P < .001). A QOL preference was also associated with older age (P = .001), male sex (P = .003), and higher educational level (P = .062). Patients who preferred LOL over QOL desired a more supportive and less pessimistic communication style from their oncologists.
  
  
  CONCLUSIONS
  These data indicate that a values preference for LOL versus QOL may be simply measured, and is associated with wishes regarding the nature of oncologist communication. Awareness of these values during the clinical encounter could improve decision making by influencing the style and content of the communication between oncologists and their patients.
authors.affiliation: Division of Medical Science and Population Science, Fox Chase Cancer Center, Philadelphia, PA 19111, USA. neal.meropol@fccc.edu
authors.forename: Neal J
authors.initials: NJ
authors.lastname: Meropol
authors.forename: Brian L
authors.initials: BL
authors.lastname: Egleston
authors.forename: Joanne S
authors.initials: JS
authors.lastname: Buzaglo
authors.forename: Al B
authors.initials: AB
authors.lastname: Benson
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Cegala
authors.forename: Michael A
authors.initials: MA
authors.lastname: Diefenbach
authors.forename: Linda
authors.initials: L
authors.lastname: Fleisher
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Miller
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Sulmasy
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Weinfurt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D008136:Longevity; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011788:Quality of Life