Dr. Secord on Understanding Patient Preferences

Angeles Alvarez Secord, MD
Published: Friday, Apr 10, 2015



Angeles Alvarez Secord, MD, gynecologic cancers specialist, Duke Cancer Center, discusses the importance of understanding patient preferences regarding treatment regimens.

If practitioners do not understand their patients’ goals for therapy, then they may not be delivering patients the best regimen, Secord says. While some patients deem survival the most important factor of their therapy, others may place quality of life higher on the list. Therefore, practitioners could possibly provide patients with a more toxic regimen that does not improve their survival in a clinically meaningful way, if they do not take their preferences into account.

What a physician thinks is an overly toxic regimen may not be the equivalent of what a patient believes is overly toxic, Secord explains. For example, one patient may be willing to accept severe toxicity in order to obtain additional time of living longer without disease, while some patients may not be able to tolerate any amount of toxicity.

As an example, Secord describes a patient who is an artist and soccer player with a preference to avoid therapy with neurotoxicity, since it will dramatically affect her livelihood and regular activities.



Angeles Alvarez Secord, MD, gynecologic cancers specialist, Duke Cancer Center, discusses the importance of understanding patient preferences regarding treatment regimens.

If practitioners do not understand their patients’ goals for therapy, then they may not be delivering patients the best regimen, Secord says. While some patients deem survival the most important factor of their therapy, others may place quality of life higher on the list. Therefore, practitioners could possibly provide patients with a more toxic regimen that does not improve their survival in a clinically meaningful way, if they do not take their preferences into account.

What a physician thinks is an overly toxic regimen may not be the equivalent of what a patient believes is overly toxic, Secord explains. For example, one patient may be willing to accept severe toxicity in order to obtain additional time of living longer without disease, while some patients may not be able to tolerate any amount of toxicity.

As an example, Secord describes a patient who is an artist and soccer player with a preference to avoid therapy with neurotoxicity, since it will dramatically affect her livelihood and regular activities.


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