Prospective survey amongst cancer patients and their respective caregivers regarding their expectations from and preferences regarding their treatment

Abstract

<title>Abstract</title> <bold>Purpose</bold> Cancer diagnosis profoundly impacts both patients and caregivers, with priorities shaped by medical, financial, and cultural factors. While patient-centred care has advanced, caregiver perspectives remain underexplored in India, where families strongly influence treatment decisions. This study examined: (1) treatment priorities of cancer patients and caregivers, (2) the degree of agreement between them, and (3) the role of financial responsibility in shaping choices. <bold>Methods</bold> A cross-sectional, multicentric survey was conducted among 373 patient–caregiver dyads from 17 medical colleges across 11 Indian states. Paired questionnaires were completed independently. Descriptive statistics summarised treatment preferences and financial contributions. Associations were tested using Chi-square/Fisher’s exact tests, correlations assessed with Spearman’s and Pearson’s coefficients, and concordance measured by kappa statistics. <bold>Results</bold> Patients predominantly prioritised “best chance of cure” (56.9%) and “longest survival” (21.4%), whereas caregivers more frequently considered treatment costs and logistics. Concordance between patients and caregivers was fair for the first preference (Kappa = 0.2742) but declined to negligible levels for subsequent choices. Financial responsibility was not significantly associated with primary treatment preference (p = 0.294). Younger caregivers were more likely to contribute financially than older ones (ρ = -0.847, p &lt; 0.01). Entry into clinical trials ranked lowest for both groups. <bold>Conclusion</bold> Patients and caregivers differ in their treatment priorities, with patients favouring survival outcomes and caregivers emphasising financial and practical considerations. These divergences highlight the importance of structured, empathetic communication to align expectations and support shared decision-making in cancer care.