Lochmann M, Girodet M, Despax J, Baudry V, Duranti J, Mastroianni B, Vanacker H, Vinceneux A, Brahmi M, Renard O, Verlingue L, Swadulz A, Amini-Adle M, Gautier J, Ducimetière F, Anota A, Cassier PA, Chvetzoff G, Christophe V
Support Care Cancer . 2026 Jan 26;34(2):129
doi : 10.1007/s00520-026-10320-x.
PMID : 41586899
ABSTRACT
Purpose: Palliative care (PC) is active continuous care for patients with life-limiting illnesses. It can be implemented early in association with life-prolonging treatments to preserve the patient's quality of life. However, both patients and oncologists are reluctant to discuss PC as the term is strongly connotated with poor prognoses and death. This study aimed to observe how oncologists introduce the concept of early PC referral integrated with a Phase I trial and what patients understand about it.
Methods: Consultations during which oncologists introduced referral to early PC to patients at the time of enrollment in a Phase I study were recorded. One-on-one interviews with the same patients were conducted and recorded. A thematic content analysis was then performed using NVIVO® software.
Results: The following themes emerged from the consultations with the oncologists: the contribution of early PC in terms of symptomatic and psychological support, its integration and entry into a Phase I trial at the same time, the anticipation of the benefits of PC support, and the perceived ambivalence between a Phase I trial and PC. Other themes emerged from the interviews conducted by the researchers after the consultations, including (mis)understanding the early PC referral integrated with a Phase I trial, information overload, the lack of knowledge about the role of PC, and the perceived ambivalence between a Phase I trial and PC.
Discussion-conclusion: Although oncologists tend to adapt their discourse to their patients, they often base it on evidence. However, patients have difficulty processing information about early PC. This study highlights the potential difficulties faced by oncologists and patients and suggests solutions, such as supporting patients in dealing with their emotions, analyzing practice, and training health professionals. The questions of "timing", "time", and "who" to refer patients to PC when setting up a Phase I trial remain paramount.
Keywords: Cancer; Early palliative care; Patient-doctor relation/communication; Phase I trial; Qualitative research; Understanding.
