title: Oncologists' End of Life Treatment Decisions.
abstract: BACKGROUND
  Optimal treatment decisions for older end-stage cancer patients are complicated, and are influenced by oncologists' attitudes and beliefs about older patients. Nevertheless, few studies have explored oncologists' perspectives on how patient age affects their treatment decisions.
  
  
  METHODS
  In-depth interviews were conducted with 17 oncologists to examine factors that influence their chemotherapy decisions for adults with incurable cancer near death. Transcripts of recorded interviews were coded and content analyzed.
  
  
  RESULTS
  Oncologists identified patient age as a key factor in their chemotherapy decisions. They believed older adults were less likely to want or tolerate treatment, and felt highly motivated to treat younger patients.
  
  
  CONCLUSIONS
  Qualitative analysis of in-depth interviews resulted in a nuanced understanding of how patient age influences oncologists' chemotherapy decisions. Such understanding may inform practice efforts aimed at enhancing cancer care at the end of life for older patients.
authors.affiliation: 1 Eastern Michigan University, Ypsilanti, USA.
authors.forename: Minnie
authors.initials: M
authors.lastname: Bluhm
authors.affiliation: 2 University of Michigan, Ann Arbor, USA.
authors.forename: Cathleen M
authors.initials: CM
authors.lastname: Connell
authors.affiliation: 2 University of Michigan, Ann Arbor, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Janz
authors.affiliation: 3 Veterans Affairs White River Junction Medical Center, Geisel School of Medicine at Dartmouth, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Bickel
authors.affiliation: 2 University of Michigan, Ann Arbor, USA.
authors.forename: Raymond
authors.initials: R
authors.lastname: DeVries
authors.affiliation: 4 VA Ann Arbor Healthcare System, MI, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Silveira
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D000066491:Clinical Decision-Making; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D000072103:Oncologists / Q000523:psychology*; D010817:Physician-Patient Relations; D036301:Qualitative Research; D013727:Terminal Care; D014481:United States
keywords: aging; chemotherapy; end-stage cancer; treatment decisions