When Treating Elders with Cancer, Communication Is Key

In the current model of medical practice, the phrase “doctor knows best” is generally an anathema. However, some seriously ill elders may actually prefer to cede some autonomy to the physician.

Among 73 patients (age range, 70–89) with recently diagnosed metastatic colon cancer, interviewers found that more than half preferred to play a passive role in some aspects of decision making, leaving treatment decisions partially or completely to physicians. These preferences were slightly although not significantly stronger among women and among patients older than 80, those with less education, and those with lower performance status. Overall, only 44% wanted complete prognostic information about likelihood of survival, with women significantly le…