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Factors associated with acceptance or rejection of recommendation for chemotherapy in a community cancer center

Levin, Mark M.D.; Mermelstein, Hindi M.D.; Rigberg, Corey M.D.


Socioeconomic, attitudinal, and psychological factors associated with acceptance or refusal of recommendations for chemotherapy were investigated in 64 consecutive patients with solid tumors or lymphoma who agreed to participate in this study. Patients filled out the Brief Symptom Inventory (BSI) and a questionnaire that investigated selected factors. Patients also were asked if they believed in, used, had used, or planned to use alternative-complementary treatments for their cancer. Eight patients refused chemotherapy against the advice of their oncologist. Frequency, percentage, mean, standard deviation, and range was coded, and differences between the groups of those who accepted and those who rejected recommendations for chemotherapy were analyzed by chisquare, using unpaired t test and the Wilcoxon two-sample test. There was a significant increase in anxiety in the total study population as compared with patients who did not have cancer. In addition, all the BSI scores except those for anxiety were higher in patients who refused chemotherapy, and the difference was statistically significant.

Mark Levin is Co-director at the Division of Hematology and Oncology, Brookdale University Hospital and Medical Center, Brooklyn, New York.

Hindi Mermelstein is Physician in Charge of Psychiatric, Oncology, and Emergency Services at North Shore University Hospital, Manhasset, New York.

Corey Rigberg is Chairman at the Department of Psychiatry, Clinical House Systems, Harrisburg, Pennsylvania.

Address correspondence and reprint requests to Mark Levin, Division of Hematology and Oncology, Brookdale University Hospital and Medical Center, One Brookdale Plaza, Brooklyn, NY 11212.

Accepted for publication October 14, 1998.

© 1999 Lippincott Williams & Wilkins, Inc.