6106 Background: Patients with advanced cancer require accurate perception of their illness in order to make informed decisions regarding their care. However, little is known about the accuracy of these patients’ illness and prognostic understanding. The objectives of this study are to 1) examine prognostic understanding in patients with advanced gastrointestinal (GI) cancers, 2) assess patient preferences for prognostic information, and 3) explore associations of perceptions with quality of life (QOL) and mood. Methods: Cross-sectional study of 50 patients within 6-12 weeks post diagnosis of advanced GI cancers (gastric, esophageal, pancreatic, and hepatobiliary). We assessed patients’ perceptions of prognosis with a 15-item questionnaire, the Perception of Treatment and Prognosis Questionnaire. QOL and mood were assessed using the Functional Assessment of Cancer Therapy-General (FACT-G) and hospital anxiety and depression scales (HADS), respectively. Results: We enrolled 50/62 (80%) consecutive eligible patients within an 11-month period. 50% (25/50) of participants responded that the primary goal of their cancer treatment was to “cure their cancer.” Similarly, 54% (27/50) reported that they were “somewhat” to “extremely likely” to be cured from their cancer. Only 22% (10/49) reported having a discussion about their end-of-life care preferences with their oncologist. 76% (38/50) reported wanting to know as many details as possible about their cancer diagnosis and treatment and 64% (32/50) rated this information as “extremely important.” Patients who perceived knowing about their prognosis as “extremely helpful” reported a better QOL (p = 0.009), lower symptoms of anxiety (p = 0.02) and depression (p = 0.02). Conclusions: Although the majority of patients report that they desire detailed information about their prognosis, half incorrectly perceived their cancer as curable and the majority did not discuss their end-of-life care preferences with their oncologist. Patients who found learning about their prognosis to be extremely helpful reported better QOL and mood. Studies of interventions to increase advanced cancer patients’ knowledge of their prognosis and to encourage end-of-life discussions are warranted.
Awareness and attitudes of primary caregivers toward end-of-life care in advanced cancer patients: A cross-sectional study
