Most patients with incurable cancer still think they'll survive, study finds

NEW YORK Many patients who receive chemotherapy for incurable cancers still believe they can beat the disease, a new study suggests. The researchers behind the study question if patients are simply in denial or doctors are skirting the truth with their patients' prognoses.

The study, published Oct. 25 in the New England Journal of Medicine, looked at about 1,200 patients receiving chemotherapy for incurable lung and colon cancers.

The research also highlights the problem of overtreatment at the end of life -- futile care that simply prolongs dying. It's one reason that one quarter of all federal Medicare spending occurs in the last year of life.

For cancers that have spread beyond the lung or colon, chemo can add weeks or months and may ease a patient's symptoms, but usually is not a cure. This doesn't mean that patients shouldn't have it, only that they should understand what it can and cannot do, cancer experts say.

But often, they do not. Dr. Jane C. Weeks at Dana-Farber Cancer Institute and researchers at several other Boston-area universities and hospitals led the study that included patients around the U.S. All had been diagnosed four months earlier with widely spread cancers and had received chemo.

Surveys revealed that 69 percent of those with lung cancer and 81 percent of those with colorectal cancer felt their treatment was likely to cure them. Education level and the patient's role in care decisions made no difference in the likelihood of mistaken beliefs about chemo's potential. Hispanics and blacks were three times more likely than whites to hold inaccurate beliefs.

Federal grants paid for most of the research.

In an accompanying editorial that appears with the study, two doctors question whether patients are being told clearly when their disease is incurable.

Patients also may have a different understanding of "cure" than completely ridding them of a disease - they may think it's an end to pain or less disability, note Dr. Thomas J. Smith of Johns Hopkins University School of Medicine and Dr. Dan L. Longo, a deputy editor at the medical journal.

• Should parents' belief in miracles trump medical expertise in end-of-life decisions?
• Doctors unveil "Choosing Wisely" campaign to cut unnecessary medical tests

"If patients actually have unrealistic expectations of a cure from a therapy that is administered with palliative intent, we have a serious problem of miscommunication," they write. "We have the tools to help patients make these difficult decisions. We just need the gumption and incentives to use them."

How should doctors have this difficult conversation with patients?

Smith told CBS This Morning that doctors should operate on an "ask, tell, ask" basis when patients are faced with a life-threatening illness. That means doctors should ask patients up front how many details they want to know about their illness. Then, they should tell patients in understandable terms their prognosis, such as by saying "based on people like you, you may have weeks or months."

While some patients may have positive attitudes and think they'll still beat the disease, Smith says he'll tell patients that doctors won't stand in the way of miracles, "but we can hope for the best but still need to plan for the worst."

The study raises concerns about unnecessary but costly medical treatments for dying patients. According to Smith, about 25 percent of Medicare dollars are spent in the last year of a patient's life and 9 percent are spent on patients in the final month of life.

"60 Minutes" reported in 2009 that Medicare paid $55 billion just for doctor and hospital bills during the last two months of lives.

Smith said having the difficult conversation with a patient about their end-of-life care may lower these costs because many patients may want to be comfortable at home, and not in a hospital.

"This really isn't about saving money, so much as honoring people's choices."

[JenniferOnno]

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[pg2109]

Warning:
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[JenniferOnno]

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[pg2109]

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[Flori12345]

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[pg2109]

Warning:
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[pg2109]

Warning:
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[pg2109]

Warning:
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[JenniferOnno]

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[pg2109]

Warning:
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[DoctorHenderson]

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[JenniferOnno]

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[pg2109]

Warning:
There is no Dr. Nathan Kisper, Dr. Mike Henderson, Dr. Smith Williams, Dr. Sedney Carey, Dr. Mac Donnald etc.. Only the big scammers hiding behind this names. Unfortunately I am the one of their victims. Be careful and don't trust them and in any of their "stories"!!!

[CannabisCancerProject]

Almost four years ago Michigan legalized medical marijuana and for the past 2 and 1/2 Years the Michigan Cannabis Cancer Project has been freely providing Cannabis oil to state licensed medical marijuana patients that have been diagnosed with cancer and have chosen to use cannabis oil instead of chemo radiation. As a result of providing cannabis oil made as instructed by Rick Simpson and following his recommended dosage of a gram a day until the cancer is in remission. I have been witnessed to over 15 cases of various cancers being eliminated with only using cannabis oil. I have had the honor of talking to Rick Simpson on several occasions and I believe the world owes Mr Simpson a debt of Gratitude for freely sharing and instructing the world on how to make this oil. At least a couple of Parents I know personaly are deeply grateful to Rick Simpson for sharing this knowlegd one such case is the parents of a 16 yr old diagnosed a year ago in July with terminal brain cancer the spider web type the parents were told that she that she would have about 18 months to live and that chemo radiation could buy her a few more months. After some research and careful consideration amongst the family members they decided to use cannabis oil as instructed by Rick Simpson and only cannabis oil not chemo radiation. Well its been a year now and she has been consuming a gram or more a day for year. The last test results in February showed that we stopped the growth and she has been living life as normal teenager with out loosing her hair and getting sick oh she also passed her drivers training with flying colors along with her DMV road test while consuming a daily dose of cannabis oil. This is just one of the cases that we provided for and have test results that prove that cannabis oil cures cancer eliminates cancer or kills cancer.
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[newsjunkie_56]

"Doctors should ask patients up front how many details they want to know about their illness".....ya know, if I were seriously ill but didn't yet know just what it was I had and my doc asked me how many details I wanted to know about my illness, THAT would pretty much tell me everything I needed to know.

[JenniferOnno]

I'm Jennifer Onno from Canada and Thanks to God Almighty for allowing me to try Dr. Henderson Hemp Oil for my lungs cancer, with gratitude to Dr. Henderson i had a miraculous healing and am telling everybody about this great Healing with his Hemp Oil.

I have been on Dr. Henderson Hemp Oil for 4months and i just went to do my Lungs Cancer test and i was told that i have no more cancer.
God am so grateful for all you have done for me concerning my health with the Help of Dr. Henderson and his Hemp Oil service.
If it was not for Dr. Henderson i would be regretting my life now and crying my eyes out.
for all those who have cancer problems please contact Dr. Henderson on via email: [e-mail] and see to your cancer problems solved.
I am a living witness of Dr. Henderson Hemp Oil Service and i am so grateful to him for saving my life. Doctor Henderson Contact:[e-mail]

Thank you Dr. Henderson

[pg2109]

Warning:
There is no Dr. Nathan Kisper, Dr. Mike Henderson, Dr. Smith Williams, Dr. Sedney Carey, Dr. Mac Donnald etc.. Only the big scammers hiding behind this names. Unfortunately I am the one of their victims. Be careful and don't trust them and in any of their "stories"!!!