Characteristics and influences on chemotherapy decision among older cancer patients – Does gender make a difference?

Purpose: The purpose of this study was to examine factors influencing chemotherapy decision among older cancer patients. Methods: Patients who had been prescribed a chemotherapy regimen with a projected greater than 50% chance of clinical benefit at an NCI designated comprehensive cancer care center were recruited. Participants were interviewed prior to the start of chemotherapy. Results: A total of 64 cancer patients participated in the study. About 95.3% were Caucasian, 40.6% were male, and mean age was 73.42 (SD 5.49 years; range from 65 to 88 years old). Data showed that older female cancer patients tended to have lower education (39.5% vs. 26.9% with high school or lower education) and were more likely to be widowed or divorced (53.6% vs. 15.4%), and lived alone (36.8% vs 7.7%). Males were more likely to have cancer diagnoses of later stages. The most important person influencing chemotherapy decision for both males and females was physician (57.7% vs. 44.7% respectively). Older male cancer patients, however, tended to think themselves (19.2%) more important than spouse or children (15.4%) when making treatment decision. On the other hand, older female cancer patients tended to think that spouse or children (28.9%) had greater influences than their own (21.1%). Most common concerns about treatment were fear of side effects (57.6%), followed by transportation (39.1%). Discussions: Study showed that older cancer male and female patients have different characteristics, cancer stages, and influencers on decision-making. Data provide important information on tailored intervention strategies to encourage chemotherapy with projected clinical benefits.