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Jung, Song, Kang, Yoon, Song, and Park: Advance Directives for Advanced Cancer Patients in Oncology Department: Single Center Experience
Original Article

The Ewha Medical Journal 2016; 39(4): 104-109.

Published online: 27 October 2016

DOI: https://doi.org/10.12771/emj.2016.39.4.104

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

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 6 April 2016       Accepted 10 August 2016

Copyright © 2016, The Ewha Medical Journal

(open-access):

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.

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.

Keywords: Advance directives, Terminal care, Chemotherapy

Figures and Tables

Table 1

Baseline characteristics (n=19)

emj-39-104-i001

ECOG, Eastern Cooperative Oncology Group.

Table 2

Contents of advance directives (n=19)

emj-39-104-i002

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

Table 3

Outcomes after completion of advance directives (n=19)

emj-39-104-i003

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

Appendix

Appendix 1

Advance directives form

emj-39-104-a001

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