Physicians’ attitude toward recurrent hypercalcemia in terminally ill cancer patients

Akira Shimada, Ichiro Mori, Isseki Maeda, Hidekazu Watanabe, Nobutaka Kikuchi, Hansheng Ding, Tatsuya Morita

    Research output: Contribution to journalArticle

    7 Citations (Scopus)

    Abstract

    Background: There is no consensus regarding whether cancer-induced hypercalcemia should be treated up until the patient’s death. The primary aim of this study was to clarify physicians’ attitude toward treating recurrent hypercalcemia in terminally ill cancer patients and associated factors.

    Methods: A nationwide, cross-sectional survey was performed involving 757 physicians of the Japanese Society for Palliative Medicine. Physicians’ attitude toward treating hypercalcemia in terminally ill patients was assessed based on the response to the question: do you agree that you provide medical treatment for recurrent hypercalcemia up until a patient’s death? As the potential determinants of physicians’ attitudes, we examined their characteristics, beliefs about hypercalcemia, and beliefs about a good death.

    Results: We obtained a total of 380 (50.2 %) analyzable responses. A total of 163 physicians (43 %) agreed that hypercalcemia should be treated up until the patient’s death, while the remaining 217 physicians (57 %) disagreed. The independent determinants of the attitude included the following: physicians’ specialty, belief that hypercalcemia treatment improves pain, belief that hypercalcemia treatment improves nausea, belief that hypercalcemia treatment improves quality of life, belief that hypercalcemia treatment prolongs life, belief that the effect of hypercalcemia treatment reduces gradually, belief that death with hypercalcemia is less distressing, and the perception that being mentally clear is important for a good death.

    Conclusion: Japanese physicians had different attitudes toward treating hypercalcemia in terminally ill patients. Physicians’ beliefs about the efficacy of medical treatment for hypercalcemia markedly influenced their attitudes. Clarifying evidence on the effect of hypercalcemia treatment on patients’ symptoms and prognoses is strongly encouraged.

    Original languageEnglish
    Pages (from-to)177-183
    Number of pages7
    JournalSupportive Care in Cancer
    Volume23
    Issue number1
    DOIs
    Publication statusPublished - 2015

    Keywords

    • Attitude
    • Hypercalcemia
    • Palliative care
    • Physician
    • Survey

    ASJC Scopus subject areas

    • Oncology

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  • Cite this

    Shimada, A., Mori, I., Maeda, I., Watanabe, H., Kikuchi, N., Ding, H., & Morita, T. (2015). Physicians’ attitude toward recurrent hypercalcemia in terminally ill cancer patients. Supportive Care in Cancer, 23(1), 177-183. https://doi.org/10.1007/s00520-014-2355-4