Expectations and quality of life of cancer patients undergoing radiotherapy

Expectations, real or false, affect the way patients respond to their illne sses. We assessed therapy-related expectations in relation to global qualit y of life in 55 cancer patients before and after radiotherapy. Factor analysis indicated that therapy-related expectations come into three broad categories-pain/emotional control, healing and tumour/symptom contro l. 35 patients expected 'healing' even though curative treatment was intend ed in only 19 and all patients had been fully informed. The expectation of healing was associated with high quality of life, and the same was true of perception of healing after radiotherapy. In the group as a whole, quality of life was little altered by radiotherapy, but it became substantially wor se in those patients who had expected healing but perceived that this had f ailed, even though physician-assessed Karnofsky status did not change. These findings indicate that the expectation of healing, in cancer patients , is a component of a good global quality of life, whereas more limited exp ectations (pain control, tumour control) relate to lower quality of life. P atients' expectations deserve further study as a novel approach to improvin g care.