Cancer Patient Preferences for Communication of Prognosis in the Metastatic Setting

Abstract

Most metastatic cancer patients want detailed prognostic information but prefer to negotiate the extent, format, and timing of the information they receive from their oncologists.

Collaborative/active participationper se does not decrease anxiety in breast cancer

“…Australian patients with metastatic cancer, especially those with a relatively better prognosis, showed a high need of detailed prognostic information. 9,33 In our study, in the metastatic groups prognosis was valued, both by the patient and the doctor, as even less important than in the early stage group. In fact, communicating prognosis to metastatic cancer patients is especially difficult, and requires considerable resources from both the patients and the doctors.…”

“…1,[6][7][8][9][10][11][12][13][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] The patients' expectations also depend on the type of the disease, 15,20 or the type of the malignancy. 13,15,19,25 Most of the literature data on the attitude of breast cancer patients towards being informed, and participation in treatment decision come from Canada, 15,17,18,26,32 the US, 7,10,25,[27][28][29][30][31]34 Australia, 6,9,…”

“What concerns me is…” Expression of emotion by advanced cancer patients during outpatient visits

“…Other research has shown that most patients want their oncologists to be willing to talk about death and dying [25,59] and cite emotional support as an important physician skill to help them cope when discussing the future [8]. Unfortunately, factors such as disease stage do not predict whether patients want to talk about end-of-life issues [41], so there is no reliable way to predict whether a given patient has concerns about death and dying.…”

Patient perspectives regarding communication about prognosis and end-of-life issues: How can it be optimised?

“…Most cancer patients want these discussions [6] and value that their physician is comfortable talking about death and dying [7], though a significant minority of patients do not wish to discuss these issues [8]. Health professionals frequently avoid providing this information because they are uncertain of how much patients want to know or fear that patients and their families will lose hope [9].…”