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Patients with incurable lung cancer often have unrealistic views of radiation therapy
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A significant majority of patients with incurable lung cancer possess unrealistic expectations about the effectiveness of palliative radiation therapy, according to study results presented at the 2012 American Society for Radiation Oncology Annual Meeting in Boston.
Lung cancer is the leading cause of cancer death in both men and women. About half of patients have metastatic disease at time of diagnosis. On average, patients with metastatic lung cancer survive less than 1 year, and fewer than 5% survive beyond 5 years, according to background information provided by researchers.
Aileen B. Chen
“The goal of our study was to assess patient understanding of the goals and limitations of palliative radiation therapy for incurable lung cancer,” Aileen B. Chen, MD, MPP, assistant professor of radiation oncology at Harvard University Medical School, said during a press conference.
Chen and colleagues used data from the Cancer Care Outcomes Surveillance Consortium, an NCI-funded, multicenter cohort study that enrolled 5,013 patients with newly diagnosed lung cancer from five geographic regions, 10 Veterans Administration sites and five large health maintenance organizations from 2003 to 2005.
Chen and colleagues identified patients aged at least 21 years who were diagnosed with incurable lung cancer. All 832 patients had stage wet IIIB or IV lung cancer at diagnosis, and they all received or were scheduled to receive palliative radiation therapy. Of them, 384 patients completed surveys.
Researchers analyzed patient responses to the question: “After talking with your doctors about radiation therapy, how likely did you think it was that radiation would help you live longer, cure your cancer, help with problems from cancer or have side effects?”
“We found that, overall, patients were optimistic that palliative radiation therapy can help them,” Chen said.
According to study results, 258 patients (67%) believed radiation was “very likely” or “somewhat likely” to help them with problems from cancer, and 298 patients (78%) believed radiation was “very likely” or “somewhat likely” to help them live longer.
“Of concern was that 64% of patients did not understand that radiation was ‘not at all likely’ to cure their cancer,” Chen said.
Prior studies suggest providers and patients may be too optimistic when predicting a prognosis for incurable cancers, leading to aggressive therapies near the end of life, the researchers said. In order to make informed decisions about their cancer care, patients must have accurate and realistic expectations about their treatment, Chen and colleagues concluded.
“These findings suggest a need to improve communication strategies surrounding treatment benefits in patients with metastatic lung cancer,” Chen said.
For more information:
Chen AB. Abstract #1. Presented at: 2012 ASTRO Annual Meeting; Oct. 28-31, 2012; Boston.
Disclosure: The researchers report no relevant financial disclosures.