Oncologist’s Representations of Anticancer Treatments for Patients With Advanced-Stage Cancer: New Perspectives From the COVID-19 Crisis

Abstract

Introduction

In the context of the COVID-19 pandemic, scientific societies of oncology issued guidelines to limit the spread of the virus, in particular by limiting the prescription of cancer treatments with palliative intent. This qualitative study adopts a psychosocial perspective to explore how oncologists experienced these guidelines, and what this reveals about their representations and practices concerning end-of-life treatments.

Methods

Conducted in a comprehensive cancer center, the study is based on a mixed-method strategy involving 10 semistructured interviews with oncologists and observation of 13 consultations.

Results

The oncologists stated that they were complying with the guidelines, which was perceived as an external argument of authority that made it easier to announce the cessation of treatment. The analysis highlights the sacralization of chemotherapy, a shared feeling of guilt at the idea of stopping cancer treatments, and a representation of palliative care as the moment when there is “nothing more to be done.”

Discussion

The fact that the oncologists reported that previous practices had been reinstated once the health crisis had passed reveals the psychosocial logics at work in their decision-making and communication practices. This study recommends the creation of workshops to raise awareness of the psychosocial factors that influence chemotherapy prescriptions in the advanced stages of the disease.