Exploring oncology care providers’ treatment decision making and its impacts on individuals who are highly marginalized with cancer

Due to racism, discrimination, stigma, mental illness and substance use issues, and homelessness, highly marginalized adults tend to die alone, in pain, with their needs unmet, and sometimes of preventable and treatable cancers. Cancer is the leading cause of death for highly marginalized adults. Oncology care providers play a critical role in providing culturally safe, effective care that aligns with individuals’ needs, but, issues such as unstable housing, transportation barriers, mental health and substance use issues can create conditions where oncology care providers are placed in a position of making treatment decisions that are challenging because, if highly marginalized adults do come to the cancer clinic, their treatments often dictate a regimen that is difficult to follow. This study will explore the factors that oncology care providers consider when making decisions about cancer care treatments for highly marginalized adults. Results will inform the development of clinical practice guidelines to support oncology care providers’ decision-making when making treatment decisions for adults who are highly marginalized.