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Review
. 2022 Feb 23;11(5):1195.
doi: 10.3390/jcm11051195.

Advance Directives in Oncology and Haematology: A Long Way to Go-A Narrative Review

Kevin Serey  1   2 , Amélie Cambriel  2   3 , Adrien Pollina-Bachellerie  2   4 , Jean-Pierre Lotz  2   5 , François Philippart  2   6
Affiliations
Review

Advance Directives in Oncology and Haematology: A Long Way to Go-A Narrative Review

Kevin Serey et al. J Clin Med. .

Abstract

Patients living with cancer often experience serious adverse events due to their condition or its treatments. Those events may lead to a critical care unit admission or even result in death. One of the most important but challenging parts of care is to build a care plan according to the patient's wishes, meeting their goals and values. Advance directives (ADs) allow everyone to give their preferences in advance regarding life sustaining treatments, continuation, and withdrawal or withholding of treatments in case one is not able to speak their mind anymore. While the absence of ADs is associated with a greater probability of receiving unwanted intensive care around the end of their life, their existence correlates with the respect of the patient's desires and their greater satisfaction. Although progress has been made to promote ADs' completion, they are still scarcely used among cancer patients in many countries. Several limitations to their acceptance and use can be detected. Efforts should be made to provide tailored solutions for the identified hindrances. This narrative review aims to depict the situation of ADs in the oncology context, and to highlight the future areas of improvement.

Keywords: advance care planning; advance directives; end of life; intensive care; malignant hemopathy; medical oncology.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Main obstacles for advance directives information and use in cancer patients.
Figure 2
Figure 2
Main parameters associated with knowledge of advance directives.
See this image and copyright information in PMC

References

    1. Miller K.D., Siegel R.L., Lin C.C., Mariotto A.B., Kramer J.L., Rowland J.H., Stein K.D., Alteri R., Jemal A. Cancer Treatment and Survivorship Statistics, 2016. CA Cancer J. Clin. 2016;66:271–289. doi: 10.3322/caac.21349. - DOI - PubMed
    1. Quaresma M., Coleman M.P., Rachet B. 40-Year Trends in an Index of Survival for All Cancers Combined and Survival Adjusted for Age and Sex for Each Cancer in England and Wales, 1971-2011: A Population-Based Study. Lancet. 2015;385:1206–1218. doi: 10.1016/S0140-6736(14)61396-9. - DOI - PubMed
    1. Soerjomataram I., Lortet-Tieulent J., Parkin D.M., Ferlay J., Mathers C., Forman D., Bray F. Global Burden of Cancer in 2008: A Systematic Analysis of Disability-Adjusted Life-Years in 12 World Regions. Lancet. 2012;380:1840–1850. doi: 10.1016/S0140-6736(12)60919-2. - DOI - PubMed
    1. Meert A.-P., Grigoriu B., Licker M., Van Schil P.E., Berghmans T. Intensive Care in Thoracic Oncology. Eur. Respir. J. 2017;49 doi: 10.1183/13993003.02189-2016. - DOI - PubMed
    1. Falanga A., Russo L., Milesi V., Vignoli A. Mechanisms and Risk Factors of Thrombosis in Cancer. Crit. Rev. Oncol. Hematol. 2017;118:79–83. doi: 10.1016/j.critrevonc.2017.08.003. - DOI - PubMed

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