Sometimes some of us just simply decide that we will not start any treatment or continue a treatment protocol simply because we don’t want to have treatment.  This type of decision is different from our deciding that a specific treatment has too many side effects for the potential upside it might provide.

Researchers set out to identify psychosocial variables and characteristics associated with cancer treatment default. They hypothesized that cancer patients who are psychologically distressed are more likely to default or: (a) refuse, delay or discontinue cancer treatment and routine patient follow up, and (b) decline offers for psychological support.

A total of 467 consecutive adult cancer patients (all cancers including prostate cancer) attending scheduled oncology follow-ups at a single academic medical center completed the Hospital Anxiety and Depression Scale and reported their preference for psychological support at baseline, 4-6 weeks and 12-18 months follow-up. Default was defined as refusal, delay or discontinuation of treatment or vi