Cancer patient preferences for communication of prognosis in the metastatic setting

Rebecca G. HAGERTY, Phyllis N. BUTOW, Peter A. ELLIS, Elizabeth A. LOBB, Susan PENDLEBURY, Natasha LEIGHL, David GOLDSTEIN, Sing Kai LO, Martin H. N. TATTERSALL

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Abstract

Purpose: To identify preferences for and predictors of prognostic information among patients with incurable metastatic cancer.
Patients and Methods: One hundred twenty-six metastatic cancer patients seeing 30 oncologists at 12 outpatient clinics in New South Wales, Australia, participated in the study. Patients were diagnosed with incurable metastatic disease within 6 weeks to 6 months of recruitment. Patients completed a survey eliciting their preferences for prognostic information, including type, quantity, mode, and timing of presentation; anxiety and depression levels; and information and involvement preferences.
Results: More than 95% of patients wanted information about side effects, symptoms, and treatment options. The majority wanted to know longest survival time with treatment (85%), 5-year survival rates (80%), and average survival (81%). Words and numbers were preferred over pie charts or graphs. Fifty-nine percent (59%) wanted to discuss expected survival when first diagnosed with metastatic disease. Thirty-eight percent and 44% wanted to negotiate when expected survival and dying, respectively, were discussed. Patients with higher depression scores were more likely to want to know shortest time to live without treatment (P = .047) and average survival (P = .049). Lower depression levels were significantly associated with never wanting to discuss expected survival (P = .03). Patients with an expected survival of years were more likely to want to discuss life expectancy when first diagnosed with metastases (P = .02).
Conclusion: 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. Copyright © 2004 by American Society of Clinical Oncology.
Original languageEnglish
Pages (from-to)1721-1730
JournalJournal of Clinical Oncology
Volume22
Issue number9
DOIs
Publication statusPublished - 2004

Citation

Hagerty, R. G., Butow, P. N., Ellis, P. A., Lobb, E. A., Pendlebury, S., Leighl, N., . . . Tattersall, M. H. N. (2004). Cancer patient preferences for communication of prognosis in the metastatic setting. Journal of Clinical Oncology, 22(9), 1721-1730. doi: 10.1200/JCO.2004.04.095

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