Cancer patients are not given enough information

Aug 01, 2008

Two thirds of cancer patients receive little or no information about the survival benefits of having palliative chemotherapy before making a decision about treatment, according to a study published today on bmj.com.

Palliative chemotherapy for patients with advanced cancer has modest survival benefits and there is an expectation in the UK that such patients should be given accurate information so they can give informed consent before starting chemotherapy.

At the advanced stages of cancer, survival gain from palliative chemotherapy treatment tends to be months rather than years.

A study by researchers from the University of Bristol, however, found that in more than two thirds of cases, patients were not given information about the survival benefits of such treatment.

The study, which was funded by Cancer Research UK, was carried out at a large teaching hospital and a district general hospital in the south west of England where 37 patients' cases were considered.

Consultations with oncologists were digitally recorded with each patient, all of whom had advanced forms of cancer. Three common cancers were chosen – colorectal, non-small cell lung, and pancreatic cancer.

The researchers used data from a study of patients' of experiences treatments (ASPECTS) to examine the extent to which survival gain was discussed when patients were offered palliative chemotherapy.

A researcher interviewed each patient before they saw the oncologist, recorded the consultation with the health professional, and then interviewed the patient again within weeks.

During the consultations, there was consistency in informing patients that a cure was not being sought for them, but the amount of information about survival benefit varied considerably.

Information given to patients about survival benefit included: numerical data ("about four weeks"); an idea of timescales ("a few months extra"); vague references ("buy you some time"); or no mention at all.

Only six patients out of 37 were given numerical data about the survival benefits of treatment.

For the majority of consultations observed (26 out of 37), discussion of survival benefit with patients was vague or it was not mentioned at all.

The researchers say there are concerns that the "intrusiveness of unfavourable numbers", in terms of months left to live, can undermine healthcare relationships and destroy hope.

They say: "Giving comprehensible and appropriate information about survival benefit is extremely difficult. In addition, the reluctance to inform patients of the limited survival gain of palliative chemotherapy may be motivated by a desire to 'protect' patients from bad news.

"However, the reluctance to address these difficulties and sensitivities may be hampering patients' ability to make informed decisions about their future treatment."

The researchers say oncologists and cancer teams have to communicate sufficient information to enable patients to make informed decisions based on realistic aspirations, but to do so in a sensitive manner and at the patient's pace.

They also recommend that oncologists receive training in how to communicate relevant information on survival benefits to their patients.

National updated information is needed about the prognosis of advanced cancer and the benefits of palliative chemotherapy as well as decision aids to help patients interpret information, say Daniel Munday and Jane Maher in an accompanying editorial.

Source: British Medical Journal

Explore further: SLNB doesn't up survival in melanoma arising in head, neck

add to favorites email to friend print save as pdf

Related Stories

Wireless electronic implants stop staph, then dissolve

Nov 24, 2014

Researchers at Tufts University, in collaboration with a team at the University of Illinois at Champaign-Urbana, have demonstrated a resorbable electronic implant that eliminated bacterial infection in mice ...

Rivers beyond regeneration

Nov 04, 2014

Best-known for his treatment of shell-shock victims in World War I, a new study examines William Rivers' crucial, but often overlooked contributions to the study of human culture – revealing how, late in ...

Identifying the many layers of a bug's design

Oct 03, 2014

(Phys.org) —Lawrence Livermore researchers have discovered additional "coats," or layers, of a bacterium spore found in the human gut that may give clues to how this organism develops, spreads and survives ...

Unraveling cell division

Sep 16, 2014

CRG researchers shed new light on mitosis. The study published in the Journal of Cell Biology describes how Topo 2 disentangles DNA molecules and is essential for proper cell division

Recommended for you

Putting the brakes on cancer

Dec 19, 2014

A study led by the University of Dundee, in collaboration with researchers at our University, has uncovered an important role played by a tumour suppressor gene, helping scientists to better understand how ...

Peanut component linked to cancer spread

Dec 19, 2014

Scientists at the University of Liverpool have found that a component of peanuts could encourage the spread and survival of cancer cells in the body.

User comments : 1

Adjust slider to filter visible comments by rank

Display comments: newest first

E_L_Earnhardt
not rated yet Aug 02, 2008
Aside from not knowing what it is, the small nubber of survivors from ANY treatment, doctors have a lot to share! Surgery, cyroablation, good luck, and prayer work about as well! COOLING, and electronics are hopes for the future!

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.