Utilizing Advance Care Planning Videos to Empower Perioperative Cancer Patients and Families

Many cancer patients pursue aggressive surgery in the hope of cancer cure or life
prolongation. However, in doing so, patients and families may avoid advance care planning;
they do not discuss specific goals and wishes should disease progress despite surgery.
Moreover, a subset of patients become critically ill following surgery, and family members
must make life-and-death decisions without knowing patient wishes. Preoperative advance care
planning—facilitating patient and family discussions concerning perioperative goals, hopes,
and fears—could empower patients and families to better choose which therapies and procedures
they want outside of the initial surgery and for the months following surgery. Advance care
planning aids exist, but none were developed for or evaluated in a surgical patient
population. Furthermore, video-based advance care planning tools are an innovative way to
better empower patients and families. Previous research shows that, with the aid of an
advance care planning video, patients and families are more knowledgeable about treatment
options and more comfortable with making decisions. Moreover, when better educated, these
patients and families frequently choose less aggressive therapies.

However, video-based advance care planning tools have not been developed or tested in a
surgical patient population. The investigators have developed and now will evaluate a
video-based advance care planning aid for cancer patients and families pursing aggressive
surgical cancer treatment. The investigators hypothesize that, in patients and family
members, the video-based decision aid will facilitate better preoperative discussions about
advance care planning between the patient and surgeon and decrease anxiety and depression
after surgery.

Inclusion Criteria:

- Patients aged 18 and older of study surgeons who are scheduled to have a surgical
procedure identified by study surgeons to the study team.

- Patients willing to give informed consent, ability to speak English, reasonably able
to read a newspaper or book (without sight impairment); reasonable able to listen to
radio, television (without hearing impairment).

Exclusion Criteria:

- Age <18 years old, non-English speaking patients who are not identified by
participating surgeons