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Background: Many people with advanced noncurable malignancies have unrealistic expectations of palliative cancer treatment, including the belief that treatment may cure their cancer. However, qualitative data describing how patients define cure or other treatment goals are lacking. We initiated a pilot study to assess patient understanding of the goals of palliative anticancer treatment.
Methods: Patients with advanced noncurable malignancy were eligible. Enrolled patients completed a structured interview with both quantitative and qualitative components to assess their understanding of treatment goals and their perceptions of clinical interactions. Additional data included age, race/ethnicity, education, type of malignancy, comorbidities, and palliative care involvement.
Results: We enrolled 30 patients initiating noncurative anticancer treatment. Ages ranged from 58 to 92 years. The most common malignancies were lung (33%) and prostate (17%) cancers. Ninety-three percent reported that their doctors explained things in “a way you can understand” and provided “as much information as you want” about treatment. However, only 53% accurately reported that treatment was “not at all likely” to cure their cancer; 40% reported some chance of cure; and 7% weren’t sure. Patient-reported definitions of cure ranged from “make it go away” to “no further symptoms” to “less pain.” Of those who reported some chance of cure, about half defined cure as eradication, but half used more traditionally palliative language. Overall, 80% reported that treatment was “very” or “somewhat” likely to help them live longer, and their definitions of “live longer” ranged from “wake up the next morning” to “20 more years” to “live to 105.”
Conclusions: Patient-reported definitions of “cure” and other reatment goals vary widely, and a substantial number of patients reported unrealistic expectations. These results suggest the need for an intervention to improve patient-physician communication to ensure that patients fully understand the goals of their palliative treatments.
Background: Many people with advanced noncurable malignancies have unrealistic expectations of palliative cancer treatment, including the belief that treatment may cure their cancer. However, qualitative data describing how patients define cure or other treatment goals are lacking. We initiated a pilot study to assess patient understanding of the goals of palliative anticancer treatment.
Methods: Patients with advanced noncurable malignancy were eligible. Enrolled patients completed a structured interview with both quantitative and qualitative components to assess their understanding of treatment goals and their perceptions of clinical interactions. Additional data included age, race/ethnicity, education, type of malignancy, comorbidities, and palliative care involvement.
Results: We enrolled 30 patients initiating noncurative anticancer treatment. Ages ranged from 58 to 92 years. The most common malignancies were lung (33%) and prostate (17%) cancers. Ninety-three percent reported that their doctors explained things in “a way you can understand” and provided “as much information as you want” about treatment. However, only 53% accurately reported that treatment was “not at all likely” to cure their cancer; 40% reported some chance of cure; and 7% weren’t sure. Patient-reported definitions of cure ranged from “make it go away” to “no further symptoms” to “less pain.” Of those who reported some chance of cure, about half defined cure as eradication, but half used more traditionally palliative language. Overall, 80% reported that treatment was “very” or “somewhat” likely to help them live longer, and their definitions of “live longer” ranged from “wake up the next morning” to “20 more years” to “live to 105.”
Conclusions: Patient-reported definitions of “cure” and other reatment goals vary widely, and a substantial number of patients reported unrealistic expectations. These results suggest the need for an intervention to improve patient-physician communication to ensure that patients fully understand the goals of their palliative treatments.
Background: Many people with advanced noncurable malignancies have unrealistic expectations of palliative cancer treatment, including the belief that treatment may cure their cancer. However, qualitative data describing how patients define cure or other treatment goals are lacking. We initiated a pilot study to assess patient understanding of the goals of palliative anticancer treatment.
Methods: Patients with advanced noncurable malignancy were eligible. Enrolled patients completed a structured interview with both quantitative and qualitative components to assess their understanding of treatment goals and their perceptions of clinical interactions. Additional data included age, race/ethnicity, education, type of malignancy, comorbidities, and palliative care involvement.
Results: We enrolled 30 patients initiating noncurative anticancer treatment. Ages ranged from 58 to 92 years. The most common malignancies were lung (33%) and prostate (17%) cancers. Ninety-three percent reported that their doctors explained things in “a way you can understand” and provided “as much information as you want” about treatment. However, only 53% accurately reported that treatment was “not at all likely” to cure their cancer; 40% reported some chance of cure; and 7% weren’t sure. Patient-reported definitions of cure ranged from “make it go away” to “no further symptoms” to “less pain.” Of those who reported some chance of cure, about half defined cure as eradication, but half used more traditionally palliative language. Overall, 80% reported that treatment was “very” or “somewhat” likely to help them live longer, and their definitions of “live longer” ranged from “wake up the next morning” to “20 more years” to “live to 105.”
Conclusions: Patient-reported definitions of “cure” and other reatment goals vary widely, and a substantial number of patients reported unrealistic expectations. These results suggest the need for an intervention to improve patient-physician communication to ensure that patients fully understand the goals of their palliative treatments.