title: Cancer patient preferences for communication of prognosis in the metastatic setting.
abstract: 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.
authors.affiliation: Medical Psychology Research Unit and Department of Medicine, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Hagerty
authors.forename: Phyllis N
authors.initials: PN
authors.lastname: Butow
authors.forename: Peter A
authors.initials: PA
authors.lastname: Ellis
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Lobb
authors.forename: Susan
authors.initials: S
authors.lastname: Pendlebury
authors.forename: Natasha
authors.initials: N
authors.lastname: Leighl
authors.forename: David
authors.initials: D
authors.lastname: Goldstein
authors.forename: Sing Kai
authors.initials: SK
authors.lastname: Lo
authors.forename: Martin H N
authors.initials: MH
authors.lastname: Tattersall
mesh_terms: 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