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Original Article

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

Byung Wook Jung, Jun Gyu Song, Sae Han Kang, Byung Woo Yoon, Yonggeon Song, Kwonoh Park1
The Ewha Medical Journal 2016;39(4):104-109. Published online: October 27, 2016

Department of Internal Medicine, Hanil General Hospital, Seoul, Korea.

1Medical Oncology and Hematology, Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.

Corresponding author: Kwonoh Park. Medical Oncology and Hematology, Department of Internal Medicine, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 50612, Korea. Tel: 82-55-360-1424, Fax: 82-55-360-1129, parkkoh@daum.net
• Received: April 6, 2016   • Accepted: August 10, 2016

Copyright © 2016, The Ewha Medical Journal

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • 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.
  • Keywords: Advance directives; Terminal care; Chemotherapy
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Appendix 1

Advance directives form

emj-39-104-a001.jpg
Table 1

Baseline characteristics (n=19)

ECOG, Eastern Cooperative Oncology Group.

emj-39-104-i001.jpg
Table 2

Contents of advance directives (n=19)

AD, advance directive; CPR, cardio-pulmonary resuscitation; ICU, intensive care unit.

emj-39-104-i002.jpg
Table 3

Outcomes after completion of advance directives (n=19)

CPR, cardio-pulmonary resuscitation; ICU, intensive care unit.

emj-39-104-i003.jpg

Figure & Data

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      Advance Directives for Advanced Cancer Patients in Oncology Department: Single Center Experience
      Ewha Med J. 2016;39(4):104-109.   Published online October 27, 2016
      DOI: https://doi.org/10.12771/emj.2016.39.4.104
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      • Citation for the content below
      Advance Directives for Advanced Cancer Patients in Oncology Department: Single Center Experience
      Ewha Med J. 2016;39(4):104-109.   Published online October 27, 2016
      DOI: https://doi.org/10.12771/emj.2016.39.4.104
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      Advance Directives for Advanced Cancer Patients in Oncology Department: Single Center Experience
      Advance Directives for Advanced Cancer Patients in Oncology Department: Single Center Experience

      Baseline characteristics (n=19)

      ECOG, Eastern Cooperative Oncology Group.

      Contents of advance directives (n=19)

      AD, advance directive; CPR, cardio-pulmonary resuscitation; ICU, intensive care unit.

      Outcomes after completion of advance directives (n=19)

      CPR, cardio-pulmonary resuscitation; ICU, intensive care unit.
      Table 1 Baseline characteristics (n=19)

      ECOG, Eastern Cooperative Oncology Group.

      Table 2 Contents of advance directives (n=19)

      AD, advance directive; CPR, cardio-pulmonary resuscitation; ICU, intensive care unit.

      Table 3 Outcomes after completion of advance directives (n=19)

      CPR, cardio-pulmonary resuscitation; ICU, intensive care unit.

      Table 1

      Table 2

      Table 3

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