title: Preferences of advanced cancer patients for communication on anticancer treatment cessation and the transition to palliative care.
abstract: BACKGROUND
  The objective of this study was to clarify the communication preferences of patients with advanced cancer regarding discussions about ending anticancer treatment and transitioning to palliative care and to explore the variables associated with those preferences.
  
  
  METHODS
  Participants were 106 Japanese patients with cancer who had been informed at least 1 week earlier about the cessation of their anticancer treatment. They completed a survey measuring their preferences for communication about ending anticancer treatment and transitioning to palliative care as well as their demographic characteristics. Medical records were also examined to investigate medical characteristics.
  
  
  RESULTS
  Results of the descriptive analysis indicated that patients strongly preferred their physicians to listen to their distress and concerns (96%), to assure them that their painful symptoms would be controlled (97.1%), and to explain the status of their illness and the physical symptoms that would likely occur in the future (95.1%). Multiple regression analyses identified the factors associated with these preferences: telling patients to prepare mentally and informing them of their expected life expectancy were associated with cancer site; sustaining hope was associated with cancer site and children; and empathic paternalism was associated with duration since cancer diagnosis.
  
  
  CONCLUSIONS
  The majority of patients preferred their physicians to be realistic about their likely future and wanted to be reassured that their painful symptoms would be controlled. For patients with cancer at certain sites, those with children, and those more recently diagnosed, physicians should communicate carefully and actively by providing information on life expectancy and mental preparation, sustaining hope, and behaving with empathic paternalism.
authors: Section of Liaison Psychiatry and Palliative Medicine, Division of Comprehensive Patient Care, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan.|Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan.
authors: Shino
authors: S
authors: Umezawa
authors: Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan.|Center for Suicide Prevention, National Institute of Mental Health, National Center for Neurology and Psychiatry, Tokyo, Japan.
authors: Maiko
authors: M
authors: Fujimori
authors: Section of Liaison Psychiatry and Palliative Medicine, Division of Comprehensive Patient Care, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan.
authors: Eisuke
authors: E
authors: Matsushima
authors: Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan.|Department of Palliative Medicine, National Cancer Center Hospital East, Chiba, Japan.
authors: Hiroya
authors: H
authors: Kinoshita
authors: Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan.|Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center, Tokyo, Japan.|Psycho-Oncology Division, National Cancer Center Hospital, Tokyo, Japan.
authors: Yosuke
authors: Y
authors: Uchitomi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology / Q000523:psychology*; D010166:Palliative Care / Q000523:psychology; D057240:Patient Preference / Q000706:statistics & numerical data*; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D011379:Prognosis; D012044:Regression Analysis; D028761:Withholding Treatment
keywords: communication; empathy; life expectancy; neoplasms; palliative care; patient preference; physician-patient relations; prognosis; treatment failure