title: Are patients open to elective re-sampling of their glioblastoma? A new way of assessing treatment innovations.
abstract: BACKGROUND
  This is a qualitative study designed to examine patient acceptability of re-sampling surgery for glioblastoma multiforme (GBM) electively post-therapy or at asymptomatic relapse.
  
  
  METHODS
  Thirty patients were selected using the convenience sampling method and interviewed. Patients were presented with hypothetical scenarios including a scenario in which the surgery was offered to them routinely and a scenario in which the surgery was in a clinical trial.
  
  
  RESULTS
  The results of the study suggest that about two thirds of the patients offered the surgery on a routine basis would be interested, and half of the patients would agree to the surgery as part of a clinical trial. Several overarching themes emerged, some of which include: patients expressed ethical concerns about offering financial incentives or compensation to the patients or surgeons involved in the study; patients were concerned about appropriate communication and full disclosure about the procedures involved, the legalities of tumor ownership and the use of the tumor post-surgery; patients may feel alone or vulnerable when they are approached about the surgery; patients and their families expressed immense trust in their surgeon and indicated that this trust is a major determinant of their agreeing to surgery.
  
  
  CONCLUSIONS
  The overall positive response to re-sampling surgery suggests that this procedure, if designed with all the ethical concerns attended to, would be welcomed by most patients. This approach of asking patients beforehand if a treatment innovation is acceptable would appear to be more practical and ethically desirable than previous practice.
authors.affiliation: Division of Neurosurgery, Toronto Western Hospital, University of Toronto, West Wing, 4th Floor Rm 4 W448, 399 Bathurst St., Toronto, ON, M5T2S8, Canada, taskia@gmail.com.
authors.forename: Taskia
authors.initials: T
authors.lastname: Mir
authors.forename: Peter
authors.initials: P
authors.lastname: Dirks
authors.forename: Warren P
authors.initials: WP
authors.lastname: Mason
authors.forename: Mark
authors.initials: M
authors.lastname: Bernstein
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000941:ethics / Q000523:psychology*; D005260:Female; D005909:Glioblastoma / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000941:ethics / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D036301:Qualitative Research; D012086:Reoperation / Q000941:ethics / Q000523:psychology*; D055815:Young Adult
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