1434P - The understanding of terminal cancer and its relationship with attitudes toward end-of-life care issues

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Palliative Care
Presenter June Koo Lee
Authors J.K. Lee1, A.R. An2, D.S. Heo3, Y.H. Yun4
  • 1Biomedical Research Center (#e7), Seoul National University Hospital, Seoul/KR
  • 2Family Medicine, Seoul National University Hospital, Seoul/KR
  • 3Internal Medicine, Seoul National University Hospital, Seoul/KR
  • 4Department Of Medicine, Seoul National University, 110-799 - Seoul/KR

Abstract

Objective

To investigate differences in the understanding of terminal cancer and determine the relationship between this understanding and attitudes toward end-of-life issues.

Design

A questionnaire survey was performed between 2008 and 2009.

Participants: A total of 1242 cancer patients, 1289 family caregivers, 303 physicians from 17 university hospitals, and 1006 participants from the general population responded (response rates: 90.1%, 95.1%, 81.0%, and 75.9%, respectively).

Main outcome measures

Individual understanding of terminal cancer and its relationship with preference for disclosure of terminal prognosis and critical end-of-life interventions.

Results

A “six-month life expectancy” was the most common understanding of terminal cancer (45.6%), followed by “treatment refractoriness” (21.1%), “metastatic/recurred disease” (19.4%), “survival of a few days/weeks” (11.4%), and “locally advanced disease” (2.5%). The combined proportion of “treatment refractoriness” and “six-month life expectancy” differed significantly between physicians and the other groups combined (76.0% vs 65.9%, P = 0.0003). Multivariate analyses showed that patients and caregivers who understood terminal cancer as “survival of a few days/weeks” showed more negative attitudes toward disclosure of terminal status compared with participants who chose “treatment refractoriness” (adjusted odds ratio [aOR] 2.39, 95% CI 1.26 to 4.54 for patients; aOR 2.94, 95% CI 1.58 to 5.47 for caregivers). Caregivers who understood terminal cancer as “metastatic/recurred” or “six-month survival” tended to disagree with withdrawing futile life-sustaining treatments (aOR 2.57, 95% CI 1.39 to 4.75 for “metastatic/recurred,” aOR 1.86, 95% CI 1.06 to 3.28 for “six-month survival”) and active pain control (aOR 2.29, 95% CI 1.13 to 4.64 for “metastatic/recurred”, aOR 1.86, 95% CI 0.97 to 3.54 for “six-month survival”), compared with caregivers who selected “treatment refractoriness.”

Conclusion

The understanding of terminal cancer varies among the four participant groups. It was associated with different preferences regarding end-of-life issues. Standardizing this terminology is needed to better understand end-of-life care.

Disclosure

All authors have declared no conflicts of interest.