Relationship Between Cancer Patients' Predictions of Prognosis and Their Treatment Preferences

Abstract

MOST METASTATIC solid tumors, including lung and colon cancer, are incurable and life expectancy is short. Cancer patients and their physicians are often faced with a fundamental choice between cancer-directed therapy and supportive care that emphasizes symptom management rather than control of the underlying disease. Even in incurable solid tumors, cancer-directed therapy may prolong average life expectancy by several months and palliate symptoms in some but is often associated with treatment-related toxic effects. There is substantial variability in the choices that are made about these alternatives. For example, among patients diagnosed as having metastatic colon cancer in 1990, 42% received chemotherapy as a component of their treatment, while 58% did not.¹