{"id":1632,"date":"2021-03-24T09:00:43","date_gmt":"2021-03-24T09:00:43","guid":{"rendered":"https:\/\/blogs.bmj.com\/spcare\/?p=1632"},"modified":"2021-03-24T09:50:01","modified_gmt":"2021-03-24T09:50:01","slug":"lets-talk-about-advanced-cancer-prognosis","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/spcare\/2021\/03\/24\/lets-talk-about-advanced-cancer-prognosis\/","title":{"rendered":"Let’s talk about advanced cancer prognosis"},"content":{"rendered":"

By Dr Helen Kerr, Senior Lecturer, School of Nursing and Midwifery, Queen\u2019s University Belfast<\/em>
\nSara Mone, Staff Nurse, Royal Victoria Hospital, Belfast
\nCorrespondence to: Dr Helen Kerr, h.kerr@qub.ac.uk
\n<\/em><\/p>\n

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For individuals with advanced cancer, being aware of their prognosis will often mean being aware of a terminal prognosis or shortened life expectancy. \u00a0Individuals with advanced cancer who are aware of their prognosis make more informed decisions about their care.\u00a0 Those who are better informed about their prognosis may choose less aggressive treatments and prefer care focused on managing their symptoms.\u00a0 They are also more likely to engage in advanced care planning discussions.<\/p>\n

Despite the benefits for individuals of being aware of their prognosis, they do not always have an accurate awareness of their prognosis, which may impact on their ability to make\u00a0 informed decisions at a crucial time in their lives.\u00a0 As the rationale for this lack of awareness is unclear, a literature review was undertaken which aimed to get an understanding of how many individuals with advanced cancer are not accurately aware of their prognosis, and the rationale for this lack of awareness.<\/p>\n

The literature review found the majority of individuals with advanced cancer were not aware of their prognosis.\u00a0 There were multiple reasons reported for the lack of prognostic awareness.\u00a0 One reason was related to the doctor not having had a conversation with the individual about their prognosis.\u00a0 When there was a conversation about the prognosis, some individuals were not able to remember the conversation due to being overwhelmed at the time of the discussion, or the subject of prognosis being discussed in vague terms.\u00a0 It was also reported the lack of accurate prognostic awareness could be due to the individual being in a state of denial about their shortened life expectancy.\u00a0 Other rationale included individuals misunderstanding the aim of treatments such as chemotherapy and radiotherapy, thinking it was to cure the cancer, or perhaps hoping it was curative. Finally, in some countries in the continent of Asia, prognostic information may not always be shared with the individual with advanced cancer unless requested, due to a fear of taking away hope from individuals.<\/p>\n

After prognostic information is shared with the individual with advanced cancer, healthcare professionals should assess whether the individual has understood the information, recognising it may require several conversations to ensure full understanding. \u00a0Although most individuals would prefer to be informed of their prognosis, it is important a person-centred approach is used in healthcare to understand and respect how much the individual would like to know about their prognosis.<\/p>\n

We would be interested in your experience on the benefits and barriers of sharing prognostic information to individuals with advanced cancer.<\/p>\n

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Article reference: Mone S, Kerr H, Prognostic awareness in advanced cancer: an integrative literature review, BMJ Supportive & Palliative Care 2021;11:53-58<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

By Dr Helen Kerr, Senior Lecturer, School of Nursing and Midwifery, Queen\u2019s University Belfast Sara Mone, Staff Nurse, Royal Victoria Hospital, Belfast Correspondence to: Dr Helen Kerr, h.kerr@qub.ac.uk   For individuals with advanced cancer, being aware of their prognosis will often mean being aware of a terminal prognosis or shortened life expectancy. \u00a0Individuals with advanced […]<\/p>\n

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