One in two Australians will be diagnosed with cancer by the age of 85. Imagining how each of those people would react to that diagnosis is hard. Predicting exactly how they’d go about deciding on a treatment option is even harder, especially when it may be invasive, intensive or high-risk.
Welcome to Richard De Abreu Lourenco’s world. The 2018 Chancellor’s Postdoctoral Research Fellow and Senior Research Fellow in the Centre for Health Economics Research and Evaluation (CHERE) is researching how patients make complex decisions about cancer care.
Right now, he’s looking at how three specific groups make decisions in real-world scenarios: women at high-risk of ovarian cancer, parents of children experiencing fevers due to cancer treatment and those receiving long-term care after surviving cancer.
“My research aims to help better target where government money should be spent in cancer care and beyond,” he says. “I hope to inform what happens, not just in cancer, but in other areas of health and how we can spend our limited health funding in the best way for patients.”
It’s something he’s been investigating since he came to study a PhD at UTS in 2013. Prior to that, Richard spent more than a decade working in the private sector researching and evaluating the economics of pharmaceuticals and medical devices. His work inspired him to delve deeper into the assumptions being made about how patients want to receive care.
“Drug companies were saying to government, for example, ‘we want you to pay more for our services because they are convenient’,” explains Richard. “For my PhD, I wanted to investigate whether people really think it’s worthwhile paying more for something like cancer treatment just because it is more convenient and how we go about measuring that.”
That research showed the importance of information – both how it’s communicated and how much is given – in the decision-making process. And how, for some decisions, such as whether to remove a healthy breast after a breast cancer diagnosis, most women wouldn’t change their decision regardless of how the choices were explained.
For Richard, it’s all about focusing on meaningful engagement with patients in a field that often pays lip service to the concept. “Quite often when we do research, we look at the things we’re doing ‘to’ people rather than doing it ‘with’ them,” he says.
“Having patients as part of my research team – helping me build the research question and understand the results – has been really valuable. There are aspects, like the importance of sensation in your breast area, which you’re just not able to understand without having lived it.”
And for governments having to make tough decisions on the ground, Richard’s research could prove to be invaluable.