Patients with advanced cancer: A survey of the understanding of their illness and expectations from palliative radiotherapy for symptomatic metastases

We conducted a pilot study to examine patients' understanding of their illn ess and their expectations for palliative radiotherapy for symptomatic meta stases. Participants were asked to complete a survey consisting of seven qu estions prior to the initial consultation. Demographic details and informat ion on extent of disease were collected. Patients were asked to score their symptom distress using the modified Edmonton Symptom Assessment System. Sixty patients participated in the pilot study between January and April 19 99. Their median age was 68 years (range 46-90). The most common primary tu mours were lung, prostate and breast. Twenty-one patients (35%) believed th at their cancer was curable. Twelve (20%) expected that palliative radiothe rapy would cure their advanced cancer and 23 (38%) believed that palliative radiotherapy would prolong their lives. Twenty-one patients (35%) had conc erns about the effectiveness of radiation therapy and twenty (33%) had conc erns about the side-effects of radiotherapy. Fifty-two (87%) were not famil iar with the concept of radiation treatment. Forty-seven patients (78%) rep orted that they were not given information about the radiation treatment; 5 1 (85%) were not satisfied with the information that their own doctors had provided regarding radiation treatment prior to the consultation at our cli nic. A significant proportion of the patients in this pilot study had misconcept ions regarding their illness and unrealistic expectations from palliative r adiotherapy. We plan to provide educational pamphlets for use in referring doctors' surgeries and clinics in order to inform patients of the nature, r ationale and anticipated benefits and side-effects of palliative radiothera py.