A recent study conducted by Dr. Suzanne Audrey, at the University of Bristol, and her colleagues found that patients with incurable cancer are often not clearly informed of what they stand to gain from palliative chemotherapy. As a result, patients may lack sufficient knowledge to make a decision based on informed consent.

The researchers observed and recorded 9 oncologists and 37 patients during consultations in which palliative chemotherapy for advanced lung, pancreas, or colon cancer was first discussed. The researchers found that in all cases, patients were told that their cancer was incurable. They were also informed about treatment options, common side effects and the associated risks in the different treatment options. However, in 8 cases, survival was not discussed at all. In an additional 18 cases, information was "vague," involving comments such as "about 4 weeks, a few months extra, and buy you some time." Moreover, only 6 patients were given numerical data about how much longer they would likely live if palliative chemotherapy were used.

"If the oncologist focuses on the benefits of palliative chemotherapy in terms of control of symptoms and quality of life, but omits information about survival benefit, the patient might assume much greater potential to prolong life than is likely to be the case," Audrey and colleagues suggest.

The authors of this study believe that oncologists should not evade the subject of life expectancy. Instead, they recommend that oncologists receive coaching on how to inform patients without taking away hope.