Stakeholder Perspectives on the Term Time Toxicity to Describe Health Care Contact Time Associated With Cancer Treatments

Abstract

Purpose: The labeling of the time-opportunity costs of cancer care as time toxicity has stimulated research into the impact of treatment time on patients, yet stakeholder views on this potentially value-laden term remain unreported. Existing qualitative research highlights significant individual differences in the perception of burden from treatment-related time. The purpose of this study was to report patient, caregiver, and oncologist reactions to the term time toxicity.

Methods: Semistructured interviews were conducted with purposively selected adults with advanced GI cancers and their caregivers from one metropolitan and one regional center, as well as GI oncologists recruited from participating sites, email, and social media advertising. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis tied to a framework approach.

Results: Forty-five people, including patients (n = 20), caregivers (n = 10), and GI medical oncologists (n = 15) were interviewed. Thematic analysis identified three major themes: (1) Critiques of toxicity, (2) supportive perspectives, and (3) alternative terminology. Although some participants felt that describing time as a treatment-related toxicity was both accurate and provided a potential benefit to health systems optimization, many felt that the word toxicity conveyed an unhelpful value judgment on time invested for treatment and could overlook positive experiences of care. Alternative value-neutral or positive terms were suggested (eg, time commitment).

Conclusion: We identified divergent perspectives on the terminology used to describe treatment-related health care contact time. These differences likely reflect subjective experiences of treatment time. Further research should explore this concept in more diverse populations.