Abstract 602P
Background
Providing information about life expectancy is considered challenging by most physicians and as a consequence, such information is often not discussed. Using 3 scenarios to explain survival times provides an accurate view of life expectancy that leaves room for realistic hope. We assessed preferences for discussing life expectancy in a cohort of women with gynecological cancer.
Methods
We recruited women with gynecological cancers at 5 sites in Norway. Participants completed a survey describing 2 formats for explaining life expectancy to a hypothetical patient with advanced cancer—providing either 3 scenarios for survival (best case, worst case, and typical scenario), or just the median survival time, or 3 scenarios plus the median survival time.
Results
A total of 252 women with a median age of 64 years completed the survey, 122 (48%) of whom reported that they were undergoing anti-cancer treatment. 90 (34%) recalled to have received prognostic information. The primary cancer type was ovarian in 110 (44%), uterine in 61 (24%), and cervical in 52 (21%) patients. Higher proportions of respondents agreed that explaining 3 scenarios (vs. median survival) would make sense (81% vs. 74%), helps to plan for the future (71% vs. 65%), and conveys hope (58% vs. 38%), while fewer respondents agreed that explaining three scenarios (vs. median survival) would upset people (29% vs. 39%). A majority of respondents preferred prognostic information presented as 3 scenarios plus median (41%), 20% preferred 3 scenarios alone, 14% preferred median alone, 8% reported no preference for any of these formats, and 16% did not respond to this item.
Conclusions
Only a third of the women recalled to have received prognostic information. Presentation of best case, worst case, and typical scenarios was considered preferable and less upsetting than presentation of the median survival time when explaining life expectancy. We recommend including 3 scenarios for survival time when discussing prognosis in women with gynecological cancer.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
K. Lindemann: Financial Interests, Personal, Invited Speaker: GSK; Financial Interests, Personal, Advisory Board: MSD, Eisai; Financial Interests, Institutional, Research Grant: GSK; Financial Interests, Institutional, Sponsor/Funding, Sponor of clinical study: GSK; Financial Interests, Institutional, Sponsor/Funding, Sponsor of clinical study: AstraZeneca, MSD, Roche, Nykode; Financial Interests, Institutional, Advisory Board: MSD; Financial Interests, Institutional, Advisory Role: AstraZeneca; Financial Interests, Personal, Leadership Role, Deputy Medical Director: NSGO; Other, Personal, Member: ASCO; Financial Interests, Personal, Member: ESGO. M.R. Stockler: Financial Interests, Institutional, Research Grant, DASL: Bayer; Financial Interests, Institutional, Research Grant, Enzamet & Enzarad: Astellas; Financial Interests, Institutional, Research Grant, KEYPAD: Amgen, MSD; Financial Interests, Institutional, Research Grant, NIVORAD: BMS; Financial Interests, Institutional, Research Grant: Pfizer, Roche; Financial Interests, Institutional, Research Grant, ADELE: Beigene; Financial Interests, Institutional, Research Grant, PARAGON2: Novartis. B.E. Kiely: Financial Interests, Personal, Advisory Board: Roche, Gilead Sciences; Financial Interests, Personal, Invited Speaker: Novartis; Other, Personal, Leadership Role: Medical Oncology Group Australia (MOGA) breast cancer group; Other, Personal, Member, strategic advisory board: Breast Cancer Network Australia (BCNA) ; Other, Personal, Member: Breast Cancer Trials Scientific Advisory Committee. I. Vistad: Financial Interests, Personal, Advisory Board: MSD, AstraZeneca, GSK; Financial Interests, Institutional, Sponsor/Funding, Clinical Trial: GSK, MSD. All other authors have declared no conflicts of interest.