title: A feasibility study of dignity therapy in patients with stage IV colorectal cancer actively receiving second-line chemotherapy.
abstract: BACKGROUND
  Randomized controlled trials support the use of dignity therapy (DT) in palliative care patients late in the course of their disease, but little is known about the feasibility of DT earlier in the course in patients with incurable malignant disease who are still receiving chemotherapy.
  
  
  OBJECTIVE
  To assess the feasibility of DT relatively early in the disease trajectory (primary endpoint) and the effect on death acceptance, distress, symptoms, quality of life, peacefulness, and advanced care planning (secondary outcome endpoint).
  
  
  METHODS
  Stage IV colorectal cancer patients who progressed on first-line chemotherapy were enrolled. Patients received DT over 2 visits and had outcome measures assessed pre-DT, immediately post-DT and 1 month post-DT.
  
  
  RESULTS
  15 of 17 patients (88%) who were approached enrolled in the study. Most of the patients who completed DT reported being satisfied and felt it was helpful, that it increased their sense of meaning, that it would be helpful to their family, and that it increased their sense of dignity, their sense of purpose, and their will to live.
  
  
  CONCLUSIONS
  This is a small study that lacks power for statistical significance of findings. There is no control group for comparison.
  
  
  CONCLUSIONS
  DT is a highly feasible, satisfying, and meaningful intervention for advanced colorectal cancer patients who are receiving chemotherapy earlier in the course of their and may result in an understanding of disease and goals of care at the end of life. Larger feasibility and exploratory studies are warranted in advanced cancer patients.
authors: Division of Hematology/Oncology, Feinberg School of Medicine, Robert H Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois, USA. Maxwell.T.Vergo@hitchcock.org.
authors: Mazwell T
authors: MT
authors: Vergo
authors: Division of Hematology/Oncology, Feinberg School of Medicine, Robert H Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois, USA.
authors: Halla
authors: H
authors: Nimeiri
authors: Division of Hematology/Oncology, Feinberg School of Medicine, Robert H Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois, USA.
authors: Mary
authors: M
authors: Mulcahy
authors: Division of Hematology/Oncology, Feinberg School of Medicine, Robert H Lurie Comprehensive Cancer Center, Northwestern University, Chicago, Illinois, USA.
authors: Al
authors: A
authors: Benson
authors: Feinberg School of Medicine and Kellogg School of Management, Buehler Center on Aging, Northwestern University, Chicago, Illinois, USA.
authors: Linda
authors: L
authors: Emmanuel
keywords: colorectal cancer; dignity therapy; distress; metastatic; terminal illness acknowledgement