Most Patients, Oncologists Have Contrary Survival Prognosis Expectations

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Those with advanced disease are likely to be more optimistic than their oncologist
Those with advanced disease are likely to be more optimistic than their oncologist

HealthDay News — Cancer patients and their oncologists often hold different opinions about the patient's chances for survival and how long they might live, according to a study published online July 14 in JAMA Oncology.

Researchers asked 236 patients with advanced cancer about their prognosis. The 38 oncologists who treated them independently said they would "not have been surprised" if their patients died within a year. The team also asked whether patients knew that their opinions about their prognosis differed from those of their oncologists and the extent to which life expectancy influenced treatment options.

The researchers found that 68% of patients rated their odds for survival differently from their oncologists. Almost all patients were more optimistic than their oncologist. Of the 68%, only 10% understood that their views and their oncologist's differed. Seven out of 10 patients surveyed said they would opt for supportive care rather than aggressive treatment as the end of their lives neared. To make an informed decision, however, patients need to know when death is imminent, the researchers said.

"Our findings suggest that patient-oncologist prognostic discordance is common in advanced cancer and that it is usually due to patients not knowing their oncologists' prognosis opinions," the authors write. "This study supports the urgent clinical and societal need to better understand what it means to communicate well about prognosis to achieve treatment that honors patients' values, preferences, and wishes."

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