A values-based advance care planning paradigm was acceptable to the vast majority of cancer outpatients, but may increase distress, found a recent study.1

“The motivation was to see if asking people about their values was tolerable and helpful, in addition to watching video decision aids,” says Andrew S. Epstein, MD, the study’s lead author and assistant attending on the Gastrointestinal Medical Oncology Service in the Department of Medicine at Memorial Sloan-Kettering Cancer Center in New York City.

The researchers previously developed the Person-Centered Oncologic Care and Choices (P-COCC), an advance care planning intervention combining a patient values interview with an informational care goals video. The P-COCC tool was acceptable to 97% of the 33 participants. However, the researchers were somewhat surprised to find that it was associated with slightly worse distress.

“All patients deserve to know what is going on with an illness, and to have their values elicited during their care so they can receive care most in line with their values,” says Epstein.


1. Epstein AS, O’Reilly EM, Shuk E, et al. A randomized trial of acceptability and effects of values-based advance care planning in outpatient oncology: Person-Centered Oncologic Care and Choices. J Pain Symptom Manage 2018; 56(2):169-177.