1378P - How long have I got? Attitudes of patients to receiving survival information formatted as three scenarios

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Psychosocial Aspects of Cancer
Presenter Belinda Kiely
Citation Annals of Oncology (2014) 25 (suppl_4): iv481-iv485. 10.1093/annonc/mdu352
Authors B.E. Kiely1, A. Martin1, P. Grimison2, L. Chantrill3, M.H.N. Tattersall2, P. Blinman2, N. Muljadi1, M. Stockler1
  • 1Nhmrc Clinical Trials Centre, University of Sydney, 1450 - Camperdown/AU
  • 2Medical Oncology, RPA and Concord Hospitals, Sydney/AU
  • 3Medical Oncology, Macarthur Cancer Centre, 2560 - Campbelltown/AU

Abstract

Aim

We developed a web-based tool to help oncologists estimate and explain best-case, typical, and worst-case scenarios for survival to patients with advanced cancer. We report here on the attitudes of patients seeking prognostic information and being given it in this format.

Methods

Oncologists were encouraged to use the tool whenever a patient with advanced cancer requested quantitative prognostic information. For each patient, the oncologist estimated the ‘median survival of a group of similar patients’ and used the tool to calculate ranges for the 3 scenarios based on this estimate. Oncologists presented the information using standardized oral and printed formats. Patients completed a questionnaire about their attitudes to receiving this format of information.

Results

47 patients of 6 oncologists have completed the questionnaire. Patients' characteristics were: median age 68 years; male 72%; high school education 56%; ECOG PS 0-1 73%; >8 weeks since diagnosis of advanced cancer 66%; primary cancer of kidney 22%, prostate 20%, pancreas 18%, colon 11%, breast 9% and other 20%. The median estimated survival time was 9 months (range 3-48). Most patients agreed that ‘having my life expectancy presented this way’ was helpful (89%), made sense (96%), improved my understanding (81%), and will help me make plans (83%); about half agreed that it was reassuring (55%), gave hope (52%), made me feel worried or anxious (49%), and was upsetting (58%). Most agreed that being told each scenario was helpful: best-case (89%), typical (83%), worst-case (85%), and median (74%). Most agreed that receiving a printed summary was helpful (85%); and, that the information would be helpful for their family members (76%) and family doctor (85%). The prognosis was considered about the same as expected by 47%, worse than expected by 28%, and better than expected by 26%. Preferences for the scenario to be told first were typical 28%, best-case 17%, worst-case 11%, and not important 45%.

Conclusions

The vast majority of patients seeking information about their survival time found it helpful to receive such information as 3 scenarios, and agreed that it would be helpful for their family members and doctors to receive this information.

Disclosure

All authors have declared no conflicts of interest.