Many terminal cancer patients put false hope in chemo, study finds
Doctors must improve their message, researchers say.
(HealthDay)—Many people with incurable cancer mistakenly believe chemotherapy may save them, a new study finds.
Researchers at Dana-Farber Cancer Institute in Boston found that more than 80 percent of people with advanced colon cancer and nearly 70 percent with advanced lung cancer thought chemo could cure their disease. In reality, chemo might give them several more months of life or ease troubling symptoms, but it rarely offers a cure for these diseases once they've spread to distant sites in the body.
"It's really easy for people to have expectations that aren't well aligned with reality," said the study's senior author, Dr. Deborah Schrag, an attending physician in adult oncology at Dana-Farber. "They want to be the one to beat the cancer. And, doctors want to be helpful. We want to be positive.
"What's clear," she added, "is that whatever we're doing right now, we need to change."
These misunderstandings may keep patients from making informed treatment decisions and preparing for death, say the study authors.
The study, published Oct. 25 in the New England Journal of Medicine, included almost 1,200 people who were part of the larger Cancer Care Outcomes Research and Surveillance study. The study volunteers were surveyed about four months after their diagnosis with advanced lung or colon cancer—cancer that had spread to other areas of their body (metastasized). Almost all were receiving chemotherapy.
Overall, 69 percent of the lung cancer patients and 81 percent with colon cancer reported unrealistic expectations about the likelihood that their chemotherapy might cure them.
People with colon cancer were more likely to believe that chemo might provide a cure, and blacks and Hispanics were significantly more likely to think that.
Patients who reported having favorable communication with their doctor were also more likely than others to expect a cure, the investigators found.
"You've been dealt a bad hand and, as your doctors, we want to help you cope," said Schrag. "But we may be robbing people of the opportunity to prioritize and make plans for what's important to them. We need to walk a fine line and have our patients hope for what's possible, but plan for what's probable."
Doctors also have to expect their popularity may drop in the face of truthful conversations, the study authors noted.
The co-author of an accompanying editorial, Dr. Thomas J. Smith, said what really matters is what people understand about their disease. "As long as these people are still planning for the worst, it's wonderful if they can be hoping for the best," he said.
Smith, director of palliative medicine at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, said that oncologists often need to change the way they deliver information to help people better understand what they can expect to happen.
"Oncologists like me are pretty good at saying to someone with lung cancer, 'This is something we can't cure.' But, that's very different than saying, 'What do you want to know about your disease?' or 'What do you understand about your disease?'" he said.
Smith said it's also important to have these types of discussions several times during the illness, and when someone has between three and six months left to live, it's important to discuss hospice care.
Misguided expectations also burden taxpayers. One-quarter of Medicare funds—the U.S. insurance program for the elderly—are spent in the year before death, in part because of late-stage chemotherapy, the editorialists noted.
"Chemotherapy can help ease symptoms, and some chemotherapy may extend life, but at some point chemotherapy can do you more harm than good," Smith said.
Schrage added, "It's important to know that chemotherapy is helpful and valuable. It's not worthless by any means. But, hopefully patients will feel empowered to ask, 'How will this help me?' and 'What is realistic for me to expect?'"
She said it's also very helpful to bring someone to your doctor's appointment, because it's often hard to focus on what the doctor is saying after you've been given difficult, life-altering news.
More information: There's more on chemotherapy at the American Cancer Society.
Journal reference: New England Journal of Medicine
Copyright © 2012 HealthDay. All rights reserved.
- Avastin no benefit to older lung cancer patients: study Apr 17, 2012 | not rated yet | 0
- Pre-op treatments boost survival for esophageal cancer patients: study May 30, 2012 | not rated yet | 0
- Phase III trial shows crizotinib superior to single-agent chemotherapy for ALK-positive lung cancer Sep 30, 2012 | not rated yet | 0
- Certain head and neck cancer patients benefit from second round of treatment Jun 13, 2011 | not rated yet | 0
- High EGFR expression a predictor for improved survival with cetuximab plus chemotherapy Jul 05, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
May 23, 2013 Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
In recent years, microRNAs (miRNAs) and other non-coding RNAs are small molecules that help control the expression of specific proteins. In recent years they have emerged as disease biomarkers. miRNA profiles have been used ...
Cancer 21 hours ago | not rated yet | 0
Cancer cells spread and grow by avoiding detection and destruction by the immune system. Stimulation of the immune system can help to eliminate cancer cells; however, there are many factors that cause the immune system to ...
Cancer 21 hours ago | 5 / 5 (1) | 0
Researchers from London's Kingston University have begun a two-year study which could help prolong the lives of people with colorectal tumours.
Cancer May 24, 2013 | 5 / 5 (1) | 0
Transformative research from Western University has identified new hormones in the body which may suppress breast cancer and stimulate the regression of breast tumors.
Cancer May 24, 2013 | 5 / 5 (2) | 0
(Medical Xpress)—Curtin University researchers have found evidence that targeting specific cells in the body can reverse the effects of cancer on the immune system.
Cancer May 24, 2013 | 5 / 5 (4) | 0
Coenzyme Q10 decreases all cause mortality by half, according to the results of a multicentre randomised double blind trial presented today at Heart Failure 2013 congress. It is the first drug to improve heart failure mortality ...
3 hours ago | not rated yet | 4
Heart failure accelerates the aging process and brings on early andropausal syndrome (AS), according to research presented today at the Heart Failure Congress 2013. AS, also referred to as male 'menopause', was four times ...
3 hours ago | not rated yet | 1
Women at a particular stage in their monthly menstrual cycle may be more vulnerable to some of the psychological side-effects associated with stressful experiences, according to a study from UCL.
21 hours ago | 3.7 / 5 (3) | 3 |
Two mutations central to the development of infantile myofibromatosis (IM)—a disorder characterized by multiple tumors involving the skin, bone, and soft tissue—may provide new therapeutic targets, according to researchers ...
19 hours ago | 3 / 5 (2) | 0 |
(AP)—Department of Justice lawyers have again asked a federal appeals court in New York to delay lifting age restrictions and prescription requirements on an emergency contraceptive popularly known as the morning-after ...
3 hours ago | not rated yet | 0
Mortality and length of stay are highest in heart failure patients admitted in January, on Friday, and overnight, according to research presented today at the Heart Failure Congress 2013. The analysis of nearly 1 million ...
3 hours ago | not rated yet | 0