Abstract P5-15-15: Survival duration and quality of life expectations in patients with metastatic breast cancer: The role of treating oncologists in influencing patients' expectations of therapy – A questionnaire-based study

Abstract

Abstract Introduction Breast cancer is the most common female cancer in the United States. Median survival for patients with metastatic disease is 18 to 24 months with some patients enjoying long term survival1,2. Multiple studies have documented that cancer patients tend to overestimate survival duration and that their understanding of their prognosis is insufficient. This is due in part to vague doctor- patient communication, Lack of information concerning the effect of alternative therapies on overall outcomes and Lack of patient understanding of the likely outcomes of their disease3,4. Objectives: To investigate the expectations of patients with metastatic breast cancer in regards to survival duration and quality of life from different treatments, and identify oncologists’ role in influencing these expectations. Methods: Electronic charts were used to select women diagnosed with metastatic breast cancer between the age of 35 and 80 treated at the cancer center at the University of Toledo medical center. A detailed questionnaire evaluated the level of comfort between patients and oncologist/s regarding survival duration and quality of life. The questionnaire also evaluated patients’ expectations from treatments they received, are receiving. Results: 40 patients were identified. 26 out of which completed the survey. The majority of patients ( 65-77 % ) expected different treatments for their metastatic disease to prolong their survival for more than 5 years. 57 to 66% of our patients stated that their expectations regarding QOL outcomes from different treatments changed after discussion with their oncologist. 7% of our patients stated that their oncologist does not spend enough time explaining what to expect from the treatment in regards to quality of life outcomes. Conclusion: Our study highlights the importance of communication between oncologists and metastatic breast cancer patients and the influential role they play in patients’ expectations regarding survival and quality of life. It is also important to recognize patients’ concerns and spend enough time explaining expected outcomes from different treatments. Although this could be challenging in busy practices, short interval follow up visits and re-addressing those concerns along with involving the palliative care team early could be a potential steps for improvement.