Most incurable cancer patients expect cure

Most U.S. incurable cancer patients say they will beat the disease, perhaps due to faith in chemotherapy, optimism or doctors not fully explaining their odds. Dr. Jane C. Weeks of the Dana-Farber Cancer Institute in Boston and colleagues said chemotherapy for metastatic lung or colorectal cancer that has spread can prolong life by weeks or months, but it is not curative. The researchers studied 1,193 patients participating in the Cancer Care Outcomes Research and Surveillance study, who were alive four months after diagnosis and received chemotherapy for newly diagnosed metastatic -- stage IV -- lung or colorectal cancer. Data were obtained from a patient survey by professional interviewers in addition to a comprehensive review of medical records. The study, published in the New England Journal of Medicine, found 69 percent of patients with lung cancer and 81 percent of those with colorectal cancer did not report understanding chemotherapy was not likely to cure their cancer. Reporting inaccurate beliefs about chemotherapy was higher among patients with colorectal cancer compared with those with lung cancer. "Many patients receiving chemotherapy for incurable cancers may not understand that chemotherapy is unlikely to be curative, which could compromise their ability to make informed treatment decisions that are consonant with their preferences," the researchers wrote in the study. "Physicians may be able to improve patients' understanding, but this may come at the cost of patients' satisfaction with them." In an accompanying editorial, Dr. Thomas J. Smith of The Johns Hopkins University School of Medicine and Dr. Dan L. Longo, a deputy editor at the medical journal, questioned whether physicians were making it clear to patients their disease was incurable.