Do We Have a Knowledge Gap with Our Patients?-On the Problems of Knowledge Transfer and the Implications at the End...

Cancer patients are often unaware of their exact diagnosis, stage of disease, and prognosis. This affects their treatment, quality of life, and end-of-life decisions. In this study, patients with skin and urological cancers were asked about their level of knowledge about their disease and its treatment in order to highlight this problem and describe possible effects on end-of-life decisions.

150 patients with advanced skin cancer and 88 patients with advanced urological cancer were interviewed using a structured questionnaire at a German university hospital. Descriptive and statistical analysis of the data were performed. The significance level was set at alpha ≤ 0.05.

67% of skin cancer patients could not state their exact stage. Of these, younger patients (<60 y) were more likely to state their stage correctly (p = 0.017). All of those patients knew about their therapy. A total of 56 patients had distant and 143 had local metastasis. The majority was aware of that (84%, 78%). Also, 95% of the urological cancer patients stated that they knew their stage of disease, but not a single patient could tell it correctly. All urological patients knew about the presence of metastasis. A total of 30% of urological cancer patients were unaware of their tumor therapy, and one patient stated that he did not receive any treatment, even though he did. The majority of patients could not correctly name their exact therapy.

In the patients observed, it was found that many of them were unaware of their stage of disease, which can have a huge impact on their end-of-life decisions, such as the type of treatment they want. Many patients were also unaware of their own treatment. There is a risk that false hopes of cure may be attached to therapies and that, as a result, patients may be less likely to opt for palliative care with a focus on maintaining quality of life.