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Unrealistic expectations and disclosure of incurability in patients with non-small cell lung cancer.
Hasegawa, Takaaki; Okuyama, Toru; Uemura, Takehiro; Matsuda, Yoshinobu; Otani, Hiroyuki; Shimizu, Junichi; Horio, Yoshitsugu; Watanabe, Naohiro; Yamaguchi, Teppei; Fukuda, Satoshi; Oguri, Tetsuya; Maeno, Ken; Inagaki, Yuji; Nosaki, Kaname; Fukumitsu, Kensuke; Akechi, Tatsuo.
Afiliación
  • Hasegawa T; Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
  • Okuyama T; Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan. okuyama@med.nagoya-cu.ac.jp.
  • Uemura T; Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan. okuyama@med.nagoya-cu.ac.jp.
  • Matsuda Y; Department of Psychiatry/Palliative Care Center, Nagoya City University West Medical Center, 1-1-1 Hirate-cho, Kita-ku, Nagoya, Aichi, 462-8508, Japan. okuyama@med.nagoya-cu.ac.jp.
  • Otani H; Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
  • Shimizu J; Department of Thoracic Oncology, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
  • Horio Y; Department of Psychosomatic Internal Medicine, NHO, Kinki-Chuo Chest Medical Center, 1180 Nagasnone-cho, Kita-ku, Sakai, Osaka, 591-8025, Japan.
  • Watanabe N; Department of Palliative Care Team, Palliative and Supportive Care, NHO Kyushu Cancer Center, 3-1-1 Notame, Mitami-ku, Fukuoka, Fukuoka, 811-1395, Japan.
  • Yamaguchi T; Department of Palliative Care Team, Palliative and Supportive Care, St. Mary's Hospital, 422 Tsufukuhoncho, Kurume-shi, Fukuoka, 830-8543, Japan.
  • Fukuda S; Department of Thoracic Oncology, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
  • Oguri T; Department of Thoracic Oncology, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
  • Maeno K; Department of Thoracic Oncology, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
  • Inagaki Y; Department of Thoracic Oncology, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa-ku, Nagoya, Aichi, 464-8681, Japan.
  • Nosaki K; Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
  • Fukumitsu K; Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
  • Akechi T; Department of Education and Research Center for Community Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
Support Care Cancer ; 32(7): 421, 2024 Jun 10.
Article en En | MEDLINE | ID: mdl-38856947
ABSTRACT

PURPOSE:

Determining whether patients' unrealistic expectations of chemotherapy as a cure were associated with their perception of the disclosure of incurability.

METHODS:

This prospective study included consecutive patients with pretreated non-small cell lung cancer from four study sites. Patients and their oncologists were asked whether they perceived the disclosure of cancer incurability. Patients were also asked if they thought that chemotherapy was curative. We followed up on whether the deceased patients received specialized palliative care 14 months after their last enrollment. Multiple regression analyses were conducted to examine the association between the expectation of chemotherapy as a cure and patient/oncologist-reported perceptions of the disclosure of incurability.

RESULTS:

We analyzed 200 patients, 77 (38.5%) of whom had unrealistic expectations of a cure. Based on patients' perceptions, incurability was disclosed to 138 (69.0%) patients, and based on their oncologists' perceptions, incurability was disclosed to 185 (92.5%) patients (patient/oncologist agreements, κ = 0.19). Patients without a perception of the oncologist's disclosure of incurability-regardless of their oncologist's perception-were more likely to have unrealistic expectations of a cure than patients for whom both patient and oncologist perceptions were present. Patients who had unrealistic expectations of chemotherapy as a cure were shown to be significantly less likely to have received specialized palliative care, after adjusting for covariates (adjusted OR, 0.45; 95% CI, 0.23-0.91; p = .027).

CONCLUSION:

Oncologists' disclosure of incurability was not fully recognized by patients, and expectations of chemotherapy as a cure were associated with patients' perception of the disclosure of incurability.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados Paliativos / Carcinoma de Pulmón de Células no Pequeñas / Neoplasias Pulmonares Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Support Care Cancer Asunto de la revista: NEOPLASIAS / SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Alemania

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidados Paliativos / Carcinoma de Pulmón de Células no Pequeñas / Neoplasias Pulmonares Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Support Care Cancer Asunto de la revista: NEOPLASIAS / SERVICOS DE SAUDE Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Alemania