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Oncology Times:
doi: 10.1097/01.COT.0000425694.56361.84
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Survey: Advanced Lung Cancer Patients Mistakenly Think Palliative Therapy is Curative

Laino, Charlene

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BOSTON—More than three-fourths of patients with incurable lung cancer believe that palliative radiation therapy is “very” or “somewhat likely” to help them live longer, according to a survey reported at the American Society for Radiation Oncology Annual Meeting (Abstract 4).

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The findings come on the heels of another survey showing that the majority of patients with advanced lung or advanced colorectal cancer—69 and 81 percent, respectively—mistakenly believe that chemotherapy can cure their disease (Weeks et al: OT, 12/10/12 ).

The results are very similar. “Both surveys point to a need to improve communication strategies surrounding metastatic disease,” said the researcher who reported the findings at the ASTRO meeting, Aileen B. Chen, MD, MPP, Assistant Professor of Radiation Oncology at Harvard University Medical School. “While it may be difficult to relate such bad news to patients, they need to have accurate and realistic expectations in order to plan for the end of their lives.”

She and her colleagues used data from the same database used in the chemotherapy study—i.e., the Cancer Care Outcomes Surveillance Consortium, an NCI-funded, multicenter cohort study covering five geographic regions, 10 Veterans Administration sites, and five large health maintenance organizations.

The analysis involved 383 adult patients who were diagnosed with incurable Stage III or IV lung cancer from 2003 to 2005, all of whom received or were scheduled to receive palliative radiation therapy.

Patients were asked, “After talking with your doctors about radiation therapy, how likely did you think it was that radiation would help you live longer, cure your cancer, help with problems from cancer, or have side effects?”

Patients were optimistic that palliative radiation therapy can help them, Chen said.

Specifically, the survey showed:

* A total of 298 patients (78%) believed radiation was “very likely” or “somewhat likely” to help them live longer.

* A total of 258 patients (67%) believed radiation was “very likely” or “somewhat likely” to help them with problems from cancer.

“Of concern was that 64 percent [of patients] did not understand that radiation was ‘not at all likely’ to cure their cancer,” Chen said.

AILEEN B. CHEN, MD, ...
AILEEN B. CHEN, MD, ...
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Benjamin Movsas, MD, Chair of Radiation Oncology at Henry Ford Hospital, who moderated a news briefing at which the findings were discussed, noted that prior research suggests that physicians and patients who are overly optimistic about the prognosis of incurable cancers are more likely to try aggressive therapies. Such treatments not only fail to help, he said, but also may prolong suffering near the end of life.

© 2012 Lippincott Williams & Wilkins, Inc.

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