がん遺伝子パネル検査で新たな治療に至らず現行のがん治療を継続していくときのがん患者の折り合い

Dealing with Reality as a Cancer Patient when Continuing Current Cancer Treatment without Possibility of New Treatment as Determined by Cancer Panel Examination

要旨

　本研究の目的は，がん遺伝子パネル検査を受けたがん患者が，検査の結果，新たな治療に至らず現行のがん治療を継続していくときのがん患者の折り合いを明らかにすることである．研究方法は質的記述的研究デザインで，研究対象は，がん遺伝子パネル検査を受け，新たな治療に至らなかったがん患者10名とし，半構造化面接法を実施した．結果，がん遺伝子パネル検査で新たな治療に至らず現行のがん治療を継続していくときのがん患者の折り合いとして，【遺伝子情報だからこそ，今後に期待できると前向きに受け取る】【新たな治療がなくても状態が安定しているので許容できる】【一筋の希望に縋らぬよう感情の振幅を自らコントロールする】【ここまで生き抜いてきた自分を信じる】【あとのない自分を理解してくれている存在がある】の5つのカテゴリーが抽出された．これらの結果から，狭まりながらもまだ少し先がある感覚や，今の自分を熟知している強みで心を統制していることが，がん遺伝子パネル検査で新たな治療に至らず現行のがん治療を継続していくときのがん患者の折り合いとして特徴づけられた．厳しい状況においても少し先が考えられる状況を見出すことが必要であり，がん患者の背景を理解しアプローチすることの重要性が示唆された．

　To clarify cancer patients' experience of dealing with reality after being notified of their cancer genomic profiling results which did not lead to new treatments, a qualitative descriptive study was performed. Semi-structured interviews were conducted with 10 cancer patients who had received cancer genomic profiling and had been notified that their results did not lead to new treatments. Their experience of dealing with reality after being notified of such results was summarized into the following 5 categories: accepting the results in a constructive manner by deeming that genetic information paves the way for future treatments, finding the situation acceptable because of one's stable condition even without new treatments, controlling one's emotional ups and downs by not clinging to something as a ray of hope, believing in oneself for having survived until now, and having people understand oneself as someone with no way out. Cancer patients' experience of dealing with reality after being notified of their cancer genomic profiling results which did not lead to new treatments were characterized by "having fewer options, but feeling that one can live a little more" and "using one's strength of fully understanding one's present self for emotional control". The results suggest that these patients need to find circumstances that allow them to think about their future even in a severe situation, and medical staff need to promote their understanding of the characteristics of genomic profiling, understand their emotions, and continuously support them to help them deal with reality.