07 Oct Most Terminally Ill Cancer Patients Not Aware Of Their Life Expectancy
MedicalResearch.com Interview with:
Holly G. Prigerson, Ph.D.
Irving Sherwood Wright Professor in Geriatrics
Professor of Sociology in Medicine
Director, Center for Research on End of Life Care
Weill Cornell Medical College
New York Presbyterian Hospital
New York City, New York 10065
Medical Research: What is the background for this study? What are the main findings?
Dr. Prigerson: Research has revealed that a majority of terminally ill cancer patients do not realize that they are dying. We wanted to know if terminally ill patients would report wanting to know their life expectancy, how many oncologists shared their life expectancy estimate for the patient with them, and how that prognostic disclosure affected the patient’s accuracy. We found that 71% of terminally ill cancer patients wanted to know their life expectancy, but only 17.6% were told it by their oncologist. Those who were told were much more realistic than those who were not told, about 17 months closer to their actual survival time from out baseline assessment.
Oncologists who shared the prognosis did not psychologically injure patients (eg make them significantly more anxious or depressed) nor was their relationship harmed.
Medical Research: What should clinicians and patients take away from your report?
Dr. Prigerson: That patients want to know their prognosis and benefit from this because they better appreciate their limited life expectancy, are more likely to complete do not resuscitate orders and this is likely to result in less unwanted, burdensome end of life care.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Prigerson: We need to understand how to communicate more effectively so that patients have better understanding of their life-expectancy and how to plan for value-consistent care at the end-of-life.
Outcomes of Prognostic Disclosure: Associations With Prognostic Understanding, Distress, and Relationship With Physician Among Patients With Advanced CancerJCO JCO.2015.61.9239; published online on October 5, 2015;
Holly G. Prigerson, Ph.D. (2015). Most Terminally Ill Cancer Patients Not Aware Of Their Life Expectancy