“How long do I have, doc?” Few answer

While most cancer doctors are candid in telling patients if their illness is terminal, very few are willing to say how long they are likely to live, a survey shows.

Dr. Christopher K. Daugherty talked about the survey results at the meeting of the American Society of Clinical Oncology.

“Physicians have been described as being poor at giving accurate prognostic information to their dying patients and these patients have also been described as overestimating their survival times,” he commented.

Yet data are lacking about how cancer specialists talk to their terminally ill cancer patients about the outlook.

Daugherty and Dr. Fay J. Hlubocky from the University of Chicago asked 1200 US-based ASCO members how they communicate with patients when “death is expected within 6 to 12 months.”

Of the 559 doctors who responded to the survey, 98 percent said they tell these patients that their cancer will eventually cause their death, but only 5 percent reported that they “always” give patients estimates of time left to live.

“Most either sometimes, rarely, or never give estimates,” Daugherty said.

However, 75 percent of these same doctors said they would want an estimate of time left to live if they had terminal cancer.

Also, only 27 percent of the cancer doctors said they had been taught during training how to discuss prognosis with their patients, the survey found. Eighty percent had no training or said the training they did have was inadequate.

“What was quite remarkable,” Daugherty said, was physicians’ “real ambivalence about what they should say, how they should say it, and when they should convey prognostic information.”

He said the study underscores the need for better education and training on how to discuss prognosis with terminally ill patients.

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