Ewha Med J.  2016 Oct;39(4):104-109. 10.12771/emj.2016.39.4.104.

Advance Directives for Advanced Cancer Patients in Oncology Department: Single Center Experience

Affiliations
  • 1Department of Internal Medicine, Hanil General Hospital, Seoul, Korea.
  • 2Medical Oncology and Hematology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea. parkkoh@daum.net

Abstract


OBJECTIVES
Advance directives (AD) are designed to protect patients' autonomy and self-determination, which mean the end of life care planning should precede before loss of their decision ability. We aimed to analyze our experience of AD at field of oncology, focusing on preference of end-of-life care and outcome in advanced cancer patients.
METHODS
A retrospective review was conducted on advanced cancer patients who underwent AD at the department of Oncology of Hanil General Hospital, between April 2013 and January 2014. AD are composed of decision about end of life care (resuscitation, ventilator, artificial tube feeding) and determination of proxy.
RESULTS
Among 23 patients who were recommended AD during study period, 19 patients (83%) successfully underwent AD. The median age was 67 years (range, 50 to 95 years) and male was predominance (84%) was observed. Most of them (90%) have not heard of AD in the past. With regard to decision of end-of-life care, decision for resuscitation and ventilator were selected only by 1 patient (5%), respectively, while 10 patients (52%) decided to receive tube feeding. Among 5 patients who underwent AD during chemotherapy, there was neither transfer to other hospital for anti-cancer treatment nor follow up loss.
CONCLUSION
AD might be applicable in advanced cancer patients at field of oncology, including also patients treated with palliative chemotherapy.

Keyword

Advance directives; Terminal care; Chemotherapy

MeSH Terms

Advance Directives*
Drug Therapy
Enteral Nutrition
Follow-Up Studies
Hospitals, General
Humans
Male
Proxy
Resuscitation
Retrospective Studies
Terminal Care
Ventilators, Mechanical

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