Researching the decisions against curative lung cancer treatment

Research Aim

The reason for the DECLINE project is to see if we can find out if there are ways to help more people to have the best possible treatment.

Research Aim


A significant number of patients who seem suitable for treatment that may cure them of their lung cancer decide not to have this treatment. We don’t know why this is or whether we can do anything to change it.

It’s this situation that Dr Emma O’Dowd is seeking to address. Dr O’Dowd was the first-ever Roy Castle Lung Cancer Foundation Research Fellow, and now she is working with the third, Dr Helen Morgan, on this study that involves interviewing people diagnosed with early-stage lung cancer.  

In a previous study, patients were interviewed about their attitudes towards the risks involved in having surgery. This showed that confidence in the surgeon was an important factor for people when deciding whether to undergo treatment.

Another factor might be distance; other studies across several types of cancer have shown that people who live a long distance from where they ae treated tend to have less treatment and therefore do less well.

‘’We’re desperate to offer people who can have it, treatment with a cure. So, if there’s something we can do to try and make that easier or break down the barriers preventing them, that’s what we’re seeking to do.’’

Dr Emma O’Dowd

Although COVID-19 and the lockdowns have taken their toll on the project, Drs O’Dowd and Morgan remain confident they can make it work.

Dr Morgan adds: ‘’I started as a researcher in the midst the pandemic, so I find myself working from home and working in a lone environment. It has also impacted on how we can approach patients.

We’d normally aim to talk to them in their own home, and at the moment that’s just not possible, so that portion of the study will just have happen a little bit later, once we can move more freely. But we can manage!’’

Expected findings and potential impact

We are not aware of research that has looked in detail at what it is that makes people with early-stage lung cancer make decisions that seem to their disadvantage.

The reason we are doing this work is to see if we can find out if there are ways that we can get more people to have the best possible treatment.

This might involve explaining things better, supporting them to make their decision, and sorting out any practical issues, such as travel difficulties, that may exist.

This charity has always supported research aimed at improving how lung cancer patients experience their journey from diagnosis through care and treatment. This project could pave the way for more people having vital treatment earlier and to greater effect.

A paper, ”What is the Definition of Cure in Non-small Cell Lung Cancer?” has been published in the journal Oncology and Therapy. This is a summary of work carried out by Dr Morgan and Dr O’Dowd.

Lead researchers: Dr Emma O’Dowd and Dr Helen Morgan / Location: Nottingham University Hospitals NHS Trust / Type of research: Patient experience