title: Effect of endurance for adverse drug reactions on the preference for aggressive treatments in cancer patients.
abstract: OBJECTIVE
  Cancer patients receiving chemotherapy will sometimes conceal their discomfort, but an excessive endurance for adverse drug reactions (ADRs) can lead to a poorer prognosis. The aim of this study was to clarify the association between ADR endurance and a preference of cancer patients for aggressive treatments.
  
  
  METHODS
  A cross-sectional study was undertaken of inpatients under 75 years of age receiving injectable systemic chemotherapy or oral chronic medications at hospitals in Japan. Subjects were asked to respond to a validated questionnaire to assess the extent of their ADR endurance and whether they would choose a novel, more aggressive therapy if their life expectancy was estimated at 2 years.
  
  
  RESULTS
  Study participants were separated into the chemotherapy group (n = 36) and the non-chemotherapy group (n = 78). In the chemotherapy group, patients who had moderate ADR endurance scores were more likely to choose the new therapy (0-33, 34-67, and 68-100 points: 0.0, 54.5, and 27.3 %; χ (2) test, p = 0.15). Additionally, every patient on long-term chemotherapy (≥3 years) had high ADR endurance scores but did not choose the new, riskier treatment. In the non-chemotherapy group, the proportion of those choosing the new therapy was linearly associated with higher ADR endurance scores (25.9, 38.2, and 64.7 %; p = 0.04).
  
  
  CONCLUSIONS
  Cancer patients may prefer aggressive therapies, even when self-estimations of ADR endurance are not very high, especially if they have been receiving chemotherapy for a short period of time. These patients should be observed with great caution.
authors.affiliation: Kagawa School of Pharmaceutical Sciences, Tokushima Bunri University, 1314-1 Shido, Sanuki, Kagawa, 769-2193, Japan, iiharan@kph.bunri-u.ac.jp.
authors.forename: Naomi
authors.initials: N
authors.lastname: Iihara
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nishio
authors.forename: Tetsuko
authors.initials: T
authors.lastname: Goda
authors.forename: Hideaki
authors.initials: H
authors.lastname: Anzai
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kagawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Houchi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kirino
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D003657:Decision Making; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000523:psychology*; D057240:Patient Preference; D016019:Survival Analysis; D017741:Survivors / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents