Patients' attitudes to risk in lung cancer surgery: A qualitative study.
OBJECTIVE
Lung cancer surgery leads to long term survival for some patients but little is known about how patients decide whether to accept the associated surgical risks. The objective of this qualitative study was to explore patients' attitudes to the risks associated with lung cancer surgery.


METHODS
Fifteen patients with resectable lung cancer, recruited via multi-disciplinary team meetings at an English tertiary referral centre, participated in semi-structured interviews to explore their attitudes to the morbidity and mortality risks associated with lung cancer surgery. Transcripts were analysed using the framework method.


RESULTS
Participants reported being 'pleased' to hear that they were suitable for surgery and felt that surgery was not a treatment to be turned down because they did not see any alternatives. Participants had some knowledge of perioperative risks, including mortality estimates; however, many voiced a preference not to know these risks and to let the medical team decide their treatment plan. Some found it difficult to relate the potential risks and complications of surgery to their own situation and appeared willing to accept high perioperative mortality risks. Generally, participants were willing to accept quite severe long-term postoperative breathlessness; however, it was apparent that many actually found this possibility difficult to imagine.


CONCLUSIONS
Patients do not necessarily wish to know details of risks associated with lung cancer surgery and may wish to defer decisions about treatment to their medical team. Investment in the doctor-patient relationship, particularly for the surgeon, is therefore important in the management of patients with lung cancer.
University of Nottingham - Division of Epidemiology & Public Health, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK. Electronic address: helen.powell5@nhs.net.
H A
HA
Powell
Public Health, Epidemiology & Biostatistics, School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
L L
LL
Jones
University of Nottingham - Division of Epidemiology & Public Health, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK; Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, City Hospital Campus, Hucknall Road, Nottingham NG5 1PB, UK.
D R
DR
Baldwin
Department of Thoracic Surgery, Nottingham University Hospitals NHS Trust, City Hospital Campus, Hucknall Road, Nottingham NG5 1PB, UK.
J P
JP
Duffy
University of Nottingham - Division of Epidemiology & Public Health, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.
R B
RB
Hubbard
School of Nursing, Midwifery and Social Work, Faculty of Medical and Human Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK.
A M
AM
Tod
University of Nottingham - Division of Epidemiology & Public Health, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.
L J
LJ
Tata
Leicester School of Pharmacy, De Montfort University, The Gateway, Leicester LE1 9BH, UK.
J
J
Solomon
University of Nottingham - Division of Epidemiology & Public Health, Clinical Sciences Building, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.
M
M
Bains
D000368:Aged; D000369:Aged, 80 and over; D001290:Attitude; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010817:Physician-Patient Relations; D013510:Pulmonary Surgical Procedures / Q000523:psychology*; D012306:Risk
Lung neoplasm; Morbidity; Mortality; Qualitative Research; Risk; Thoracic surgery