Advanced Cancer Patients Frequently Mistaken Regarding Chemotherapy’s Ability to Cure

Although chemotherapy can ease pain and prolong life in advanced cancer patients, it is often not a cure

Results from a recent, nationwide study indicate that patients with advanced lung or colorectal cancer are often overly confident about chemotherapy’s ability to cure.

The study, led by researchers at Dana-Farber Cancer Institute, found that 81% of patients with advanced colorectal cancer and 69% of patients with advanced lung cancer did not realize that their chemotherapy treatments were not at all likely to cure their disease. It is extremely rare for chemotherapy to cure these types of advanced cancer.

The findings, published in the October 25 issue of the New England Journal of Medicine, derive from the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium, a large nationwide study focused on the many aspects of cancer care in the United States.

The study’s lead author, Jane Weeks, MD, MSc, noted that, “If patients do not know whether a treatment offers a realistic possibility of cure, their ability to make informed treatment decisions that are consistent with their preferences may be compromised. This misunderstanding may pose obstacles to optimal end-of-life planning.” Weeks is the scientific chair of CanCORS Consortium and is director of the McGraw/Patterson Center for Population Sciences at Dana-Farber. She is also professor of medicine at Harvard Medical School and Professor of Health Policy and Management at Harvard School of Public Health.

For the study, 1274 patients at hospitals, clinics, and treatment centers across the country were surveyed, and a comprehensive review of their medical records was conducted. Study participants had been diagnosed with metastatic lung or colorectal cancer at least 4 months prior and had received chemotherapy for their disease.

This was the first study to consist of a large and diverse cross section of the US population. The study revealed that patients from varied backgrounds treated in many different health care settings held inaccurate expectations about the role of chemotherapy.

Patients who highly rated their communication with their physician were the most likely to hold overly optimistic views about the curative potential of chemotherapy. However, a considerable minority of study participants did comprehend the incurable nature of their disease.

Study coauthor Deborah Schrag, MD, MPH, said, “skilled clinicians can set realistic expectations without their patients losing either hope or trust.” However, strategies need to be identified for physicians to regularly set realistic expectations and thus help patients make good decisions about their care.

Source: Dana-Farber Cancer Institute.