Study Looks at Terminal Cancer Patients' Expectations of ChemotherapyA majority of patients who opt to receive chemotherapy to treat newly diagnosed metastatic lung or colorectal cancer believe chemotherapy might cure their cancer, according to a recent survey. The survey results suggest that optimistic assumptions about the benefits of chemotherapy may hamper patients’ abilities to make informed treatment decisions that align with their preferences, said the researchers who led the study. The findings were published October 25 in the New England Journal of Medicine.
Dr. Jane Weeks of the Dana-Farber Cancer Institute and her colleagues interviewed 1,193 patients tracked by the prospective, observational Cancer Care Outcomes Research and Surveillance Consortium (CanCORS) study, 4 to 7 months after diagnosis. All of the patients had been diagnosed with stage IV lung or colorectal cancer and had chosen to receive chemotherapy. A surrogate was interviewed when a patient was too ill to participate. The survey asked patients how likely it was that chemotherapy would cure their disease, extend life, or relieve symptoms. The researchers also collected data on patients’ physical functioning, communication with their physicians, and social and demographic factors.
The majority of patients did not appear to understand that chemotherapy was very unlikely to cure their cancer (81 percent of those with colorectal cancer and 69 percent of those with lung cancer). Black, Hispanic, and Asian/Pacific Islander patients were more likely than white patients to believe that chemotherapy would cure them. Nevertheless, most patients believed that chemotherapy was more likely to extend their life than cure them.
Educational level, functional status, and the patient’s role in treatment decision making were not associated with inaccurate expectations about chemotherapy.
In an accompanying editorial, Drs. Thomas J. Smith of the Johns Hopkins Sidney Kimmel Cancer Center and Dan L. Longo of the National Institute on Aging wrote, “if patients actually have unrealistic expectations of a cure from a therapy that is administered with palliative intent, we have a serious problem of miscommunication that we need to address.”
This research was supported by grants from the National Institutes of Health (U01 CA093344, U01 CA093332, U01CA093324, U01 CA093348, U01 CA093329, U01 CA093339, and U01 CA093326).