Dec 14 Dying cancer patients are less likely to
want aggressive end-of-life care if they watch a short video
about CPR than if they simply hear about it, according to a U.S.
The researchers, whose results appeared in the Journal of
Clinical Oncology, found that in a group of 150 cancer patients
thought to have less than a year to live, 48 percent wanted CPR
after being told about it.
Compared to that, only 20 percent in the group who also
watched a video showing the compressions being done on a dummy
as well as a breathing tube being inserted said they would opt
for the procedure.
"These are huge differences. You will die very differently
if you watch the video than if you don't," said lead author
Angelo Volandes, from Boston's Massachusetts General Hospital.
"All these patients had a terminal condition. It's not like
there was another treatment they were trying... So (CPR) was
prolonging the dying process."
The new study builds off previous research with similar
findings by the same group. The earlier research, however, was
only conducted with brain cancer patients at one medical center.
For the current study, researchers included a wider variety
of cancer patients at four medical centers in Massachusetts, New
York and Tennessee.
All of the patients who agreed to participate in the study
were read a standardized description of CPR, which was described
as pressing on their chest and using an electric shock to "get
your heart to beat again if it stops."
The description also said CPR does not revive most patients
with advanced cancer, and the patient would likely be put in the
intensive care unit on a breathing machine if it worked.
Researchers then randomly selected 70 patients to watch a
three-minute video demonstration. Nine out of every ten patients
who watched the video said it was "helpful."
"It's one of the most important issues in American medicine
today," said Volandes. "People are getting medical interventions
that, if they had more knowledge, they would simply not want."
Susan Gaeta, an assistant professor at The University of
Texas MD Anderson Cancer center in Houston, said she likes the
idea of using the videos, but they need to be part of a bigger
"What we're trying to do is have conversation with patients
on what their goals and values are," she said, adding that the
question should not be "Do you want this?" but rather "Is this
medically appropriate based on your goals and values?"
(Reporting from New York by Andrew Seaman, editing by Elaine