Posted on November 7th, 2012 by
Patients with advanced, incurable cancer may have the inaccurate belief that chemotherapy can cure their cancer, according to the results of a study published in the New England Journal of Medicine—and such misconceptions could compromise their ability to make informed treatment decisions.
Chemotherapy is the primary treatment approach for metastatic colorectal and lung cancers. Although the treatment can prolong life—by weeks or months—it is not likely to produce a cure. While chemotherapy may prolong life and provide some relief from symptoms of disease, it is also associated with substantial side effects. Patients facing incurable cancer must weigh the risks and benefits of a treatment that will not cure their disease, but could prolong their life. Unfortunately, the reasons for choosing chemotherapy treatment in the face of incurable disease may be unclear to patients.
Researchers conducted a study that included 1,193 patients participating in a national, prospective, observational cohort study called the Cancer Care Outcomes Research and Surveillance study (CanCORS). All patients had received chemotherapy for newly diagnosed, metastatic lung or colorectal cancer and were alive four months after diagnosis. The researchers used interviews to assess patient expectations regarding chemotherapy and determine the prevalence of the belief that chemotherapy might be curative.
The researchers found that most patients did not understand that chemotherapy would not be curative. In fact, 69 percent of patients with lung cancer and 81 percent of those with colorectal cancer did not understand that chemotherapy was not at all likely to cure their cancer. The risk of holding inaccurate beliefs about chemotherapy was higher among patients with colorectal cancer than those with lung cancer and also among nonwhite and Hispanic patients and compared with non-Hispanic white patients. Patients who reported that they had favorable communication with their physician also had a higher chance of holding inaccurate beliefs. Educational level, functional status, and the patient’s role in decision-making did not appear to be associated with inaccurate beliefs about chemotherapy.
The researchers concluded that many patients receiving chemotherapy for incurable cancers may not understand that the treatment is unlikely to cure their disease. Physicians may be able to improve this understanding—but it could come at the cost of patient satisfaction with them.
Weeks JC, Catalano PJ, Cronin A, et al. Patients’ expectations about effects of chemotherapy for advanced cancer. New England Journal of Medicine. 2012; 367: 1616-1625.
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