A feasibility study of dignity therapy in patients with stage IV colorectal cancer actively receiving second-line chemotherapy.

BACKGROUND

Randomized controlled trials support the use of dignity therapy (DT) in palliative care patients late in the course of their disease, but little is known about the feasibility of DT earlier in the course in patients with incurable malignant disease who are still receiving chemotherapy.

OBJECTIVES

To assess the feasibility of DT relatively early in the disease trajectory (primary endpoint) and the effect on death acceptance, distress, symptoms, quality of life, peacefulness, and advanced care planning (secondary outcome endpoint).

METHODS

Stage IV colorectal cancer patients who progressed on first-line chemotherapy were enrolled. Patients received DT over 2 visits and had outcome measures assessed pre-DT, immediately post-DT and 1 month post-DT.

RESULTS

15 of 17 patients (88%) who were approached enrolled in the study. Most of the patients who completed DT reported being satisfied and felt it was helpful, that it increased their sense of meaning, that it would be helpful to their family, and that it increased their sense of dignity, their sense of purpose, and their will to live.

LIMITATIONS

This is a small study that lacks power for statistical significance of findings. There is no control group for comparison.

CONCLUSIONS

DT is a highly feasible, satisfying, and meaningful intervention for advanced colorectal cancer patients who are receiving chemotherapy earlier in the course of their and may result in an understanding of disease and goals of care at the end of life. Larger feasibility and exploratory studies are warranted in advanced cancer patients.