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. study.
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 conversation.
"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?" SOURCE: bit.ly/TP4QV1
(Reporting from New York by Andrew Seaman, editing by Elaine Lies)