Abstract 467P
Background
Cancer care has been transformed with the advent of new personalized and targeted therapies, and integration of specialist palliative care (PC). Comparatively little is understood about the patient experience in this modern context. This study aims to examine the experience of oncology patients receiving treatment at a tertiary care center.
Methods
We recruited patients with advanced solid cancer (N=200) from medical oncology clinics of the Duke Cancer Institute. Participants completed the modified COMPASS questionnaire (mCOMPASS), assessing a broad range of topics including quality of life (QoL), quality of care (QoC), healthcare utilization, and preferences for treatment and decision making. We summarized responses descriptively and used regression models to examine associations between variables of interest.
Results
The survey response rate was 56.1%. Patients unaware of their advanced cancer diagnosis reported better QoL. Despite all having advanced cancer diagnoses, most participants did not receive PC services (85.0%) and approximately half (49.2%) reported having an advance care plan (ACP). Those receiving PC services had lower (worse) mean QoL scores. In decision-making, most reported valuing their own opinion the most (60.3%), followed by their doctors’ (31.3%), and then their family’s (8.4%). Those reporting prognostic awareness were more likely to have an ACP and have discussed their treatment preferences with family members (p<0.05).
Conclusions
Patients with advanced cancer undergoing treatment at a large tertiary cancer center exhibit high QoL and awareness of PC, but underuse of PC services persists. The worse QoL seen in patients receiving PC services is likely a reflection of late referrals and/or the referral of patients with more significant issues (i.e., being referred only when their needs are unable to be addressed well enough with standard cancer care). The relationship between poor prognostic awareness and better QoL warrants further examination.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
T. Leblanc.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.