Objective: When cancer progresses, changes of treatment are proposed and discussed with patients and their family caregivers (P&Cs). However, insufficient research has been conducted on these important consultations. The objective of this study was therefore to explore the role of shared decision-making (SDM) during these consultations.
Methods: A thematic analysis was conducted on 20 semi-structured interviews with healthcare professionals, including nine oncologists, five surgeons, and six nurses, as well as 15 interviews with P&Cs (ten patients and five family caregivers).
Results: Five themes emerged: (1) a decision guided by the medical team; (2) communication about cancer progression and the new treatment: from information to emotion management; (3) the quality of the relationship between the healthcare professional, patient, and family caregiver; (4) the perception and role of choice in cancer progression consultations; and (5) prospects for shared decision-making. The findings revealed an imbalance in decision-making roles, with physicians primarily making treatment decisions in interdisciplinary meetings, before presenting them to P&Cs in consultation.
Conclusions: While cancer progression consultations meet the conditions for SDM, adjustments are needed to enhance the involvement of P&Cs, who often feel passive. Strengthening communication strategies and more actively integrating P&Cs could foster a more balanced, patient-centered approach.