The influence of patient expectations regarding cure on treatment decisions

ObjectiveTo test whether cancer patients’ expectations for cure prior to interacting with their oncologist influence their decisions to follow treatment recommendations. Further, to test whether patients’ expectations for cure are affected by the strength of the oncologist–patient alliance or the extent to which companions (if present) share patients’ expectations for cure.MethodsInteractions of 101 patients (and 114 companions) with oncologists about treatment were coded for the strength of the oncologist–patient alliance. Prior to the interaction, patients and companions reported expectations about whether the patient would be cured of cancer. After the interaction, patients reported whether they intended to follow the recommended treatment.ResultsPatients who expected a cure were more likely to report an intention to follow oncologists’ treatment recommendation when the strength of their alliance with their oncologist was weaker (B = −0.51, p < .05). Patients whose expectations for cure matched their companions’ expectations were less likely to report intentions to follow treatment recommendations (B = −0.28, p < .05).ConclusionPatients who have an expectation of being cured of cancer prior to meeting with their oncologist are more likely to intend to follow recommended treatment when their alliance with the oncologist is weaker and their companions do not believe they will be cured.Practice implicationsTo better understand patient treatment decisions and improve overall cancer care, oncologists should be aware of the complex ways that patients’ expectations about cure influence treatment choices.