Alique Topalian, Research Scientist of Survivorship and Supportive Services at the University of Cincinnati Cancer Center, shared a post on LinkedIn:
”New Publication Alert!
When Patients Decline Lung Cancer Surgery: Understanding the Why – and the Impact
Surgical resection is the standard of care for early-stage non-small cell lung cancer (NSCLC). But what happens when patients decline recommended surgery?
Our study explored not only outcomes – but also the social and relational factors influencing these critical decisions.
What we found:
17% of patients declined surgery
Those who declined were more likely to be: Black and Lower-income
Many faced social challenges:
- Food insecurity (21%),
- Lack of transportation (14%),
- Housing instability (7%)
Patient-provider relationship matters:
- 60% reported lack of trust in their physician
- 40% reported poor communication
- Themes included limited understanding of cancer and prior negative healthcare experiences
The consequences were significant:
- More treatment delays
- Worse recurrence-free survival (40% vs. 95.8%)
- Lower 5-year survival (40% vs. 91.7%)
Why this matters:
Decisions about cancer treatment don’t happen in isolation. They are shaped by trust, communication, and social context.
To improve outcomes, we must:
- Strengthen patient-provider relationships
- Address social determinants of health
- Improve communication and cancer education
- Deliver more equitable, patient-centered care
Bottom line:
Improving survival isn’t just about treatment – it’s about building trust and removing barriers so every patient can access and feel confident in life-saving care.
Thankful to our study team for their work on this project: Melinda Butsch Kovacic, Sofia Wagemaker Viana, Shesh Rai, Jack Kues.”
Title: Oncologic outcomes after declining lung cancer surgery: mixed methods analysis of a prospective pilot cohort
Authors: Robert M. Van Haren, Alique Topalian, Melinda Butsch Kovacic, Sofia W. Viana, Allison Moore, Catherine G. Pratt, Shesh Rai, John
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