title: Awareness of incurable cancer status and health-related quality of life among advanced cancer patients: a prospective cohort study.
abstract: BACKGROUND
  Many patients near death report an interest in knowing their prognoses. Patients' awareness of disease status may lead to more appropriate care and maintained or improved quality of life. However, it is not known whether advanced cancer patients' awareness of disease status is associated with patients' quality of life.
  
  
  OBJECTIVE
  We aimed to examine the effect of patients' awareness of disease status on the health-related quality of life (HRQOL) among advanced cancer patients undergoing palliative chemotherapy.
  
  
  METHODS
  In this prospective cohort study, patients were followed-up at 4-6 weeks and 2-3 months after the initial palliative chemotherapy. Patients' awareness of disease status, and demographic and clinical characteristics were assessed at baseline, and depression and anxiety using the Hospital Anxiety and Depression Scale (HADS) and HRQOL using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) were assessed three times.
  In total, 100 patients with advanced cancer starting palliative chemotherapy were recruited from two tertiary university hospitals and from the Korea National Cancer Center.
  
  
  RESULTS
  Patients with advanced cancer undergoing palliative chemotherapy experienced deteriorated HRQOL. Of these, the patients who were aware of their disease status as incurable had significantly higher role (p=0.002), emotional (p=0.025), and social functioning (p=0.002), and lower fatigue (p=0.008), appetite loss (p=0.039), constipation (p=0.032), financial difficulties (p=0.019), and anxiety (p=0.041) compared with patients unaware of disease status.
  
  
  CONCLUSIONS
  Our findings demonstrate the importance of patients' awareness of disease status to HRQOL.
authors.affiliation: Division of Cancer Control, Research Institute, National Cancer Center, Goyang, Gyeonggi, Korea.
authors.forename: Myung Kyung
authors.initials: MK
authors.lastname: Lee
authors.forename: Sun Kyung
authors.initials: SK
authors.lastname: Baek
authors.forename: Si-Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Dae Seog
authors.initials: DS
authors.lastname: Heo
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Yun
authors.forename: Sook Ryun
authors.initials: SR
authors.lastname: Park
authors.forename: Jun Suk
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001007:Anxiety / Q000523:psychology; D001364:Awareness; D003866:Depressive Disorder / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000523:psychology*; D010166:Palliative Care / Q000523:psychology*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology; D014342:Truth Disclosure; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents