Cancer Patient Preferences for Communication of Prognosis in the Metastatic Setting Academic Article uri icon

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abstract

  • PurposeTo identify preferences for and predictors of prognostic information among patients with incurable metastatic cancer.Patients and MethodsOne hundred twenty-six metastatic cancer patients seeing 30 oncologists at 12 outpatient clinics in New South Wales, Australia, participated in the study. Patients were diagnosed with incurable metastatic disease within 6 weeks to 6 months of recruitment. Patients completed a survey eliciting their preferences for prognostic information, including type, quantity, mode, and timing of presentation; anxiety and depression levels; and information and involvement preferences.ResultsMore than 95% of patients wanted information about side effects, symptoms, and treatment options. The majority wanted to know longest survival time with treatment (85%), 5-year survival rates (80%), and average survival (81%). Words and numbers were preferred over pie charts or graphs. Fifty-nine percent (59%) wanted to discuss expected survival when first diagnosed with metastatic disease. Thirty-eight percent and 44% wanted to negotiate when expected survival and dying, respectively, were discussed. Patients with higher depression scores were more likely to want to know shortest time to live without treatment (P = .047) and average survival (P = .049). Lower depression levels were significantly associated with never wanting to discuss expected survival (P = .03). Patients with an expected survival of years were more likely to want to discuss life expectancy when first diagnosed with metastases (P = .02).ConclusionMost metastatic cancer patients want detailed prognostic information but prefer to negotiate the extent, format, and timing of the information they receive from their oncologists.

authors

  • Hagerty, Rebecca G
  • Butow, Phyllis N
  • Ellis, Peter
  • Lobb, Elizabeth A
  • Pendlebury, Susan
  • Leighl, Natasha
  • Goldstein, David
  • Lo, Sing Kai
  • Tattersall, Martin HN

publication date

  • May 1, 2004