An evaluation of the current practices followed by oncologists in private practice in Cape Town, South Africa, in the management of patients with advanced cancer which no longer responds to anticancer treatment and the identification of the needs associated with such management

Managing patients whose disease has become unresponsive to anticancer treatment confronts oncologists with major stressors which may range from the management of distressing physical symptoms to complex psychosocial issues. These sets of circumstances prompted the undertaking of this study: An evaluation of the current practices followed by oncologists in private practice in Cape Town, South Africa, in the management of patients with advanced cancer which no longer responds to anticancer treatment and the identification of the needs associated with such management. A descriptive qualitative study was selected for data collection. Cross-sectional, in-depth semi structured face to face interviews were conducted with fifteen radio-oncologists working in five satellite units of a private oncology company in Cape Town. The interviews were conducted with the aid of a topic guide. The process of coding was employed to organise and manage the collected data. The following six themes which had a bearing on the main topic were distilled from the data: Oncologists' experiences pertaining to the management of patients with advanced disease; the difficult discussion necessary when a patient's disease became incurable and when it had to be decided whether anticancer treatment should be stopped; the decision to stop anticancer treatment; advance directives; oncologists’ burnout and the palliative care team approach. A description of challenging aspects associated with the management of terminally ill cancer patients is given. Identified needs include training of staff in palliative care; guidance for oncologists regarding the discussion of and the decision to stop anticancer treatment; implementation of advance directives; the development and employment of a multidisciplinary approach to provide palliative care; and support for oncologists facing burnout. Recommendations were made pertaining to appropriate training in the field of palliative care; the development of guidelines to aid oncologists in the discussion of and decision to stop anticancer treatment and the implementation of advance directives; the provision of palliative care through employment of a multidisciplinary approach led by a palliative care physician; and external support which should be provided by the oncologists' company to prevent and treat burnout.

Grantor dc:publisher.institution

Department of Public Health and Family Medicine

Year dc:date.issued

2014

Author dc:creator

• Grove, Jan

Advisor dc:contributor.advisor

• Gwyther, Liz

Language dc:language.iso

eng

Handle dc:identifier.uri

http://hdl.handle.net/11427/12646

OAI identifier oai:identifier

oai:open.uct.ac.za:11427/12646