Realistic Expectations Are a Good Thing

Chemotherapy for end-stage lung and colorectal cancer unlikely to cure

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Hope is an important part of fighting cancer. But unrealistic optimism in the final stages of cancer can influence important patient decisions.

A recent study surveyed end-stage lung and colorectal cancer patients about their expectations for chemotherapy.

Researchers found the majority of patients were mistaken in their belief that chemotherapy could wholly cure them of cancer, rather than simply treating it.

"There are many treatment options - talk to your oncologist."

Jane Weeks, MD, MSc, professor of medicine at Harvard Medical School and professor of Health Policy and Management at Harvard School of Public Health, was the lead author of this study.

For the study, 1,193 patients from Cancer Outcomes Research and Surveillance (CanCORS), a national observation study, were surveyed.

Each of the patients had been diagnosed at least 4 months earlier and had gone through chemotherapy for spreading, end-stage lung or colorectal cancer.

Unfortunately, chemotherapy for spreading, end-stage lung or colorectal cancer is an unlikely cure the disease.

Professional interviewers, who asked questions about what the patients expected from chemotherapy treatment and why they had those expectations, completed the surveys.

Survey results showed that 69 percent of lung cancer patients and 81 percent of colorectal cancer patients reported they thought the chemotherapy would cure them of cancer.

Black and Hispanic patients were more likely than white patients to report these optimistic beliefs.

Education level and current level of function did not appear to be associated with this optimism. Patient satisfaction with doctor-patient communication was associated with optimism.

Dr. Weeks said, “This misunderstanding may pose obstacles to optimal end-of-life planning.”

Deborah Schrag, MD, MPH, coauthor of the study recommends, “[F]urther research will be necessary to identify strategies to help physicians more consistently set realistic expectations and thereby help patients make good decisions about their care.”

This study was published in October in The New England Journal of Medicine.

Funding for this study was provided by grants from the National Cancer Institute and the Department of Veterans Affairs.

No conflicts of interest were reported.

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Review Date: 
October 25, 2012
Last Updated:
October 26, 2012