Abstract P5-15-04: Prognostic understanding and associations with mood and quality of life in patients with metastatic breast cancer

Abstract

Abstract Background: Data suggest that patients with metastatic cancer who understand their prognosis are more likely to prefer and receive care concordant with their wishes. Despite the importance of prognostic information for patients’ decision-making, there are no current data describing prognostic understanding in patients with metastatic breast cancer (MBC). The aims of this study were to describe prognostic understanding in patients with MBC and to explore its associations with mood, distress, and quality of life (QOL). Methods: We conducted a cross-sectional study of 50 patients who were receiving first- or second-line chemotherapy for MBC. Participants completed a series of questionnaires. We used a 13-item questionnaire to assess patients’ perceptions of their prognosis and goal of therapy. We evaluated mood, level of distress, and QOL using the Hospital Anxiety and Depression Scale (HADS), the Distress Thermometer (DT), and the Functional Assessment of Cancer Therapy-Breast (FACT-B), respectively. Results: The majority of patients (92%) reported it was at least somewhat important to know details about their prognosis. 19/47 (40%) patients reported that the primary goal of treatment was to cure their cancer, and 21/46 (46%) patients reported that the chance of cure was at least somewhat likely (≥25% chance of cure). 24/49 (49%) patients viewed themselves as terminally ill. There was a high prevalence of psychological morbidity in our patient cohort. 24/48 (50%) patients screened positive for distress (distress thermometer ≥4), 17/50 (34%) patients reported significant anxiety symptoms (HADS-Anxiety ≥ 8), and 11/50 (22%) patients reported significant depression symptoms (HADS-Depression ≥ 8). Distress, depression, and anxiety were each associated with lower QOL scores (93.0 vs. 114.0, p<0.001; 87.9 vs. 107.8, p=0.002; and 85.5 vs. 112.8, p<0.001, respectively). Patients who acknowledged their illness as terminal reported higher depression than those who did not perceive themselves as terminally ill (M=6.1 vs. 2.5, p=0.0006). Conclusion: Although the majority of patients with MBC receiving first- or second-line chemotherapy feel it is important to know detailed information about their prognosis, many incorrectly perceive that their cancer is curable. Accurate prognostic understanding was associated with increased depression symptoms. This study highlights the need to develop interventions to enhance patients’ prognostic understanding while providing adequate psychosocial support. Citation Format: Amanda Parkes, Jennifer A Shin, Helen Knight, Stephen M Schleicher, Areej El-Jawahri, Lara Traeger, Jennifer S Temel. Prognostic understanding and associations with mood and quality of life in patients with metastatic breast cancer [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P5-15-04.