Cancer patient preferences for communication of prognosis in the metastatic setting.
OBJECTIVE
To identify preferences for and predictors of prognostic information among patients with incurable metastatic cancer.


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).


CONCLUSIONS
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.
Hagerty
Rebecca G
RG
Medical Psychology Research Unit and Department of Medicine, University of Sydney, Sydney, New South Wales, Australia.
Butow
Phyllis N
PN
Ellis
Peter A
PA
Lobb
Elizabeth A
EA
Pendlebury
Susan
S
Leighl
Natasha
N
Goldstein
David
D
Lo
Sing Kai
SK
Tattersall
Martin H N
MH
D000328:Adult; D000368:Aged; D001007:Anxiety; D003142:Communication; D003863:Depression; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000473:pathology* / Q000523:psychology*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011379:Prognosis; D014342:Truth Disclosure