Oncologists need to better discuss patient life expectancy

May 24, 2016 by Andrea Kott, Cornell University

Despite their nearness to death, a sizeable proportion of advanced cancer patients remain unaware of basic information about their illness or its treatment, researchers from Weill Cornell Medicine report. Reviewing test results with their oncologist not only improves patients' understanding of the fatal nature of their illness, but also helps to inform their decisions about care.

The study, published May 23 in the Journal of Clinical Oncology, compared ' understanding of their before and after undergoing scans that staged their , and before and after discussing results with their oncologist. Before their scans, nine of the 178 patients acknowledged being at the end stage of with just months to live.

"We were astonished to learn that only 5 percent of this sample had sufficient knowledge about their illness to make informed decisions about their care," said Dr. Holly G. Prigerson, the Irving Sherwood Wright Professor in Geriatrics and professor of sociology in medicine who, along with co-author Dr. Paul K. Maciejewski, directs the Center for Research on End-of-Life Care at Weill Cornell Medicine.

"These were people with highly lethal metastatic cancers that had progressed after at least one prior line of chemotherapy; their was approximately four months from our interview," she said. "Many did not know that they were at the end-stage of their illness nor that their cancer was incurable. They were basically making in the dark."

Delivering sensitive information to dying patients is difficult for many oncologists and many avoid such discussions. Indeed, 38 percent of the patients had never discussed their prognoses with their oncologist. But without those conversations, Prigerson noted, patients are unable to make rational medical decisions.

"The results of this study show that when advanced cancer patients reported having recently discussed their life expectancy with their , their illness understanding improved significantly," she said. "That information may also help patients prioritize how they wish to spend the last few months of their lives, some by fulfilling bucket lists. Treatment choices patients make might follow from these priorities."

The researchers urge oncologists to discuss where the patient is on their stage of illness and their life expectancy at every appointment, even if it feels repetitive. "Talking about these things at the current visit will have the greatest influence on patients," she added.

Explore further: End-of-life talks aid in Latino advance care planning

Related Stories

End-of-life talks aid in Latino advance care planning

May 20, 2016
Communication about end-of-life care can improve how likely Latino patients with terminal cancer are to sign a do-not-resuscitate (DNR) order, helping to close the gap with white patients, according to research by Weill Cornell ...

Inaccurate life expectancy in CA not usually from medical source

April 4, 2016
(HealthDay)—Most patients with advanced cancer are inaccurate in their life expectancy estimates (LEEs), and the source of that information typically is not a medical provider, according to a study published online March ...

Does palliative chemotherapy palliate?

March 4, 2014
Terminal cancer patients who receive chemotherapy in the last months of their lives are less likely to die where they want and are more likely to undergo invasive medical procedures than those who do not receive chemotherapy, ...

Chemotherapy and quality of life at the end of life

July 23, 2015
Chemotherapy for patients with end-stage cancer was associated with worse quality of life near death for patients with a good ability to still perform many life functions, according to an article published online by JAMA ...

How cancer patients can manage pain

May 11, 2016
Studies suggest between 20 to 50 percent of cancer patients are in pain when they are first diagnosed with cancer. Approximately 80 percent of patients with advanced cancer say they are in moderate to severe pain. But not ...

Unrealistic expectations for many men with localized prostate CA

May 19, 2016
(HealthDay)—Men with localized prostate cancer (LPC) often have unrealistic survival expectations, according to a study published in the May/June issue of the Annals of Family Medicine.

Recommended for you

MR spectroscopy imaging reveals effects of targeted treatment of mutant IDH1 gliomas

May 18, 2018
Using a novel imaging method, a Massachusetts General Hospital (MGH) research team is investigating the mechanisms behind a potential targeted treatment for a subtype of the deadly brains tumors called gliomas. In their report ...

Breath test breakthrough for early diagnosis of oesophageal and gastric cancer

May 18, 2018
A breath test can successfully detect oesophageal and gastric cancer and could be used as a first-line test for patients, say researchers.

Particle shows promise to prevent the spread of triple-negative breast cancer

May 18, 2018
USC researchers have pinpointed a remedy to prevent the spread of triple-negative breast cancer. Metastatic breast cancer is a leading cause of death for women. The findings appear today in Nature Communications.

Dilemma for cancer patients as life-saving meds are tied to vision loss

May 18, 2018
(HealthDay)—A newer type of cancer treatment may offer the chance of longer survival, but the drugs could also trigger new side effects, such as vision problems.

Polygenic scores to classify cancer risk

May 18, 2018
Polygenic risk scores could be useful to stratify the risk of several cancers among patients in medical centers, allowing for the potential discovery of new associations between genes, disease and secondary effects, according ...

A way to prevent pancreatic cancer from spreading post-surgery?

May 17, 2018
Scientists at Cold Spring Harbor Laboratory (CSHL) have solved a mystery about how pancreatic cancer spreads following surgery in patients whose tumor is successfully removed. After surgery, patients' typically experience ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.