Patients Misunderstand Goals of Palliative Radiation Therapy

Many patients with incurable lung cancer mistakenly believe that radiation therapy administered for palliative treatment of pain and other cancer symptoms represents a potential cure, according to a study presented at the ASTRO 54th Annual Meeting.¹

“Our study found that, though most lung cancer patients are optimistic about the effectiveness of radiation therapy in relieving symptoms and prolonging life, many have inaccurate beliefs about the ability of palliative radiotherapy to cure their cancer,” said lead author Aileen B. Chen, MD, a radiation oncologist at Dana-Farber Cancer Institute in Boston, Mass­achusetts. “To help patients make informed decisions about radiation treatments near the end of life, healthcare providers need to improve communication with patients and understanding about the goals and limitations of palliative radiotherapy. While palliative radiotherapy can be very effective at relieving symptoms from cancer, overly intensive care can reduce patients’ quality of life and lead to significant time and financial burdens for patients and their families.”

The Cancer Care Outcomes Research and Surveillance (CanCORS) Con­so­r­tium study was a population-based and health system–based prospective cohort study. It enrolled 5013 patients with newly diagnosed lung cancer in 5 geographic regions, 10 Veterans Admin­istration sites, and 5 large health maintenance organizations from 2003 to 2005.

atients older than age 21 with stage IIIB or IV lung cancer scheduled to have radiation therapy completed a baseline interview about 4 months after diagnosis. Responses to the following question were analyzed: “After talking with your doctors about radiation therapy, how likely did you think it was that radiation would...”

Surveys were completed by 384 patients about their beliefs. Median survival was 11.5 months. More than three-quarters (78%) of patients believed that radiation was very likely or somewhat likely to help them live longer; 43% believed that radiation was very likely or somewhat likely to cure their cancer. About two-thirds (67%) believed that radiation was very likely to somewhat likely to help them with problems from lung cancer, and 66% believed that radiation therapy was very likely or somewhat likely to have side effects or complications. Only 36% correctly believed that radiation therapy was not at all likely to cure their disease.

These results suggest that physicians need to take the lead in educating end-stage lung cancer patients about the risks versus benefits of radiation therapy. Physicians may be concerned that plain speaking will take away hope, but data suggest that honest discussions empower patients to make decisions that are right for them, Chen noted.

Reference

1. Chen AB, Cronin A, Weeks J, et al. Patient beliefs about palliative radiation therapy (RT) in incurable lung cancer. Presented at: American Society for Radiation Oncology 54th Annual Meeting; October 29, 2012; Boston, MA. Abstract 4.