Gaps in patients’ understanding of palliative chemotherapy. Can we better communicate that treatment is not curative?

ABSTRACT

Introduction and Areas covered: Misunderstanding in cancer patients receiving chemotherapy is common. 50% of cancer chemotherapy is given with palliative intent. Many patients receiving chemotherapy for incurable cancer may not understand that chemotherapy is unlikely to be curative.

Cancer patients expect to share treatment decisions with their oncologist. Provision of a question prompt list (QPL) and endorsement by physicians enhances patient participation in consultations and promotes patient questions about prognosis.

Audio-recordings of oncologist consultations with newly detected incurable cancer patients document that most patients were informed about the aim of cancer treatment and that their disease was incurable. Oncologists checked patient understanding in only 10% of consultations.

Expert commentary: This review identifies gaps in patient understanding of palliative chemotherapy and examines incurable cancer patients expectations of treatment.

KEYWORDS:

• Incurable cancer
• misunderstanding
• palliative chemotherapy
• estimating/discussing prognosis
• promoting patient questions
• sharing treatment decisions
• patient hope
• denial

Acknowledgments

I acknowledge with thanks the contribution of research colleagues to the views expressed in this review. The colleagues are: Phyllis Butow, Martin Stockler, Belinda Kiely, Melina Gattellari, Ron Epstein.

Declaration of interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

No funding to declare.