Planning for End of Life

Area of Science:

• Oncology
• Palliative Care
• Patient Communication

Background:

• Discussions about treatment, outcomes, and end-of-life planning are crucial for advanced cancer patients.
• Many patients lack adequate care and end-of-life planning, potentially influenced by external information and personal beliefs.
• Patient perception of disease may be shaped by factors beyond clinical encounters.

Purpose of the Study:

• To assess patient understanding of treatment goals compared to provider perspectives.
• To identify discrepancies in understanding between patients and oncologists regarding cancer curability and prognosis.
• To explore specific factors contributing to these discrepancies.

Main Methods:

• A questionnaire-based survey was conducted in an outpatient cancer clinic.
• 100 patients with stage IV non-curable lung, gastrointestinal, or other cancers participated.
• Inclusion criteria required patients to have had at least two visits with their oncologist.

Main Results:

• 40% of patients believed their disease might be curable, contrasting with physician assessments.
• Patients who believed their disease was not curable were more likely to have discussed worsening cancer and end-of-life plans with their doctor.
• A significant percentage (20%) of patients told their disease was not curable still believed it might be curable, especially younger patients.

Conclusions:

• A substantial number of stage IV cancer patients exhibit misunderstandings regarding their disease's curability and treatment goals.
• These misconceptions can persist even after direct communication from physicians about the non-curable nature of the cancer.
• Improved communication strategies are needed to align patient and provider understanding of prognosis and advance care planning.