title: Addressing the Palliative Setting in Advanced Lung Cancer Should Not Remain a Barrier: A Multicenter Study.
abstract: Implementation of early palliative care (EPC) into daily oncology practice remains difficult. One of the barriers preventing oncologists from starting EPC is open communication about the palliative setting. The aim of this study was to investigate the relevance of this communication barrier.
  
  
  
  In this cross-sectional multicenter study, 106 patients with advanced thoracic cancer were issued a questionnaire to survey 3 dimensions of interest: illness understanding, observation of conversation regarding prognosis and end-of-life (EoL) care, and information preferences of the patients.
  
  
  
  Only 45% of subjects were aware that their treatment was not curative. When comparing presumed treatment goals between patients who were aware that their treatment could not cure them and patients likely to think that their treatment could cure them, 39% of the former chose quality of life versus 9% of the latter, whereas 36% of the former chose cure versus 13% of the latter (χ2= 17.7, P = .001). Seventy-five percent never had a conversation about EoL care. More than 50% found a discussion about prognosis and EoL care to be very important.
  
  
  
  This study reveals the existence of a communication barrier and underlines the importance of sustained emphasis with regard to the palliative intent of the treatment. Patients who are aware that they could not be cured were more aware of the primary goal of their treatment, namely quality of life. Most patients did not discuss prognosis and EoL care despite their wish for such a communication.
authors.affiliation: Department of Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium. Electronic address: annelies.janssens@uza.be.
authors.forename: Annelies
authors.initials: A
authors.lastname: Janssens
authors.affiliation: Department of Pulmonology-Thoracic Oncology, AZ Groeninge, Kortrijk, Belgium.
authors.forename: Sofie
authors.initials: S
authors.lastname: Derijcke
authors.affiliation: Department of Pulmonology-Thoracic Oncology, ZNA STER, Antwerp, Belgium.
authors.forename: Anneke
authors.initials: A
authors.lastname: Lefebure
authors.affiliation: Department of Pulmonology-Thoracic Oncology, AZ Monica, Antwerp, Belgium.
authors.forename: Elke
authors.initials: E
authors.lastname: Vandenbroucke
authors.affiliation: Department of Pulmonology-Thoracic Oncology, Ghent University, Ghent, Belgium.
authors.forename: Veerle
authors.initials: V
authors.lastname: Surmont
authors.affiliation: Department of Pulmonology, Sint Dimpna Ziekenhuis, Geel, Belgium.
authors.forename: Dieter
authors.initials: D
authors.lastname: Coeman
authors.affiliation: Department of Pulmonology-Thoracic Oncology, ZNA Middelheim, Antwerp, Belgium.
authors.forename: Daniëlle
authors.initials: D
authors.lastname: Galdermans
authors.affiliation: Department of Pulmonology, Sint-Jozefkliniek Bornem & Willebroek, Willebroek, Belgium.
authors.forename: Ann-Marie
authors.initials: AM
authors.lastname: Morel
authors.affiliation: Department of Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Birgitta I
authors.initials: BI
authors.lastname: Hiddinga
authors.affiliation: Department of Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium.
authors.forename: Jan P
authors.initials: JP
authors.lastname: van Meerbeeck
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium / Q000453:epidemiology; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D000072103:Oncologists; D010166:Palliative Care; D057240:Patient Preference; D010817:Physician-Patient Relations; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: Advanced cancer; Communication; Goals of therapy; Palliative care; Quality of life