• Posted August 26, 2025

Many Cancer Patients Say Doctors Aren't Honoring Their Treatment Desires

Frequently, patients with advanced cancer simply want to be made as comfortable as possible as they wind down their final days.

Doctors aren’t listening to their desires, a new study indicates.

Many of these patients are receiving treatment focused on extending their lives rather than easing their pain, researchers reported Aug. 25 in the journal Cancer.

In fact, they are twice as likely to say they’re receiving unwanted life-extending care than patients with other critical illnesses, results show.

“This disconnect between what patients want and what they feel they’re getting is an important issue,” lead researcher Dr. Manan Shah said in a news release.

“Doctors need to have open conversations with patients about their goals, clearly explain the intent of the treatment they are providing, and try to reconcile any real or perceived discordance between goals and treatment,” said Shah, a medical oncologist at UCLA.

Cancer treatment generally aims to both extend a person’s life and improve their quality of life, but those goals are sometimes at odds, researchers said.

“When treating advanced cancer, the goal is to help patients live as long and as well as possible,” Shah said. “But sometimes, patients and oncologists face tough choices, especially when the goals of living longer and staying comfortable begin to compete with one another.”

To see how patients feel about their care, researchers surveyed nearly 1,100 patients with diseases severe enough to require advanced care planning. Of the group, about 21% had advanced cancer and the rest serious illnesses.

Cancer patients had similar two-year death rates to those of people with other diseases, 16% versus 13%.

About 49% of patients with advanced cancer wanted comfort-focused care, similar to 48% of patients with other life-threatening illnesses.

Nevertheless, about 37% of cancer patients who wanted comfort-focused care said they were instead getting treatment aimed at extending their lives, results show.

“We found that a relatively large portion of patients with advanced cancer who had a goal to prioritize their comfort reported that their treatment was at odds with that goal,” researchers wrote.

By comparison, only 19% of patients with other diseases felt they were getting unwanted life-extending care rather than being made comfortable.

What’s more, life-extending care didn’t seem to make any difference in those who didn’t want to receive it.

There was no significant difference in two-year death rates between those who got the comfort care they wanted and those who got unwanted life-extending treatment, results show.

Doctors could be to blame, by being wishy-washy rather than talking straight with their patients, researchers said.

“In a survey of 4,074 oncologists, most reported reluctance to initiate discussions about goals of care for patients with advanced cancer who appeared well, did not have symptoms or had not exhausted all treatment options,” researchers wrote. “Oncologists’ reported reluctance to initiate discussions about care goals for such patients is worrisome as studies suggest that most patients expect their clinicians to initiate goals of care discussions.”

The conclusion: “Ultimately, our findings suggest a need for more timely and effective communication about goals of care and treatment intent in advanced cancer,” researchers wrote.

More information

The American Cancer Society has more about palliative care.

SOURCES: American Cancer Society, news release, Aug. 25, 2025; Cancer, Aug. 25, 2025