In a study about what 1,000 cancer patients expected from their chemotherapy treatments, the majority of late-stage cancer patients thought the chemotherapy could give them a cure. The problem, though, is that chemotherapy treatments could only extend life for these patients, not cure it.
But despite the medical research to the contrary, 69 percent of lung cancer patients and 81 percent of colorectal cancer patients gave responses “that were not consistent with understanding that chemotherapy was very unlikely to cure their cancer,” Wonkblog’s Sarah Kliff reports. That was not what some of the researchers expected:
“I was really surprised,” says lead study author Jane Weeks, a professor at Harvard Medical School. “Prior studies have suggested maybe a third of patients don’t understand. Those studies are done in the optimal setting though, and this was the first to look at a big population. I thought the numbers were disturbingly high.”
The most surprising finding in this study, though, might come from when the researchers looked at what the patients’ thought of their doctors. The survey asked about how good their oncologists were at communicating about treatment.
Patients who rated their doctors as the very best communicators, the most open and honest, were the most likely to have the unrealistic, inaccurate expectations.
“This suggests that patients perceive physicians as better communicators when they convey a more optimistic view of chemotherapy,” the authors conclude. “Similarly, the finding that patients, especially those with colorectal cancer, who were treated in integrated networks were somewhat more likely to understand that chemotherapy is not curative suggests that providers may be able to improve patients’ understanding if they feel it is part of their professional role.”
The fact that patients think more highly of their doctors when they’re being told optimistic information about their treatments could be problematic as Obamacare regulation beginning this month will tie some hospital payments to how highly patients rate their hospital experience. “This is a cautionary tale,” Weeks told Wonkblog. “I think everybody agrees that satisfaction alone is an incomplete measure of quality. It doesn’t give you the whole story. I think this is an example of that.”
A 2011 poll about palliative care showed that 96 percent of doctors said that it’s more important to improve dying patients’ quality of life than to prolong their lives as long as possible. Presumably, the same idea should apply to patients going through cancer treatments so that they can know as much as possible about their treatments and understand the most likely outcomes.