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Using scenarios to explain life expectancy in advanced cancer: attitudes of people with a cancer experience

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Abstract

Purpose

We sought the attitudes of people with a cancer experience to using best case, worst case, and typical scenarios for survival to explain life expectancy.

Methods

Oncology clinic attendees and Breast Cancer Network Australia (BCNA) members completed a survey describing two formats for explaining life expectancy to a hypothetical patient with advanced cancer—providing either three scenarios for survival or just the median survival time.

Results

Characteristics of the 505 respondents from outpatient clinics (n = 251) and BCNA (n = 254) were median age of 58 years, female 74 %, and breast primary 64 %. More respondents agreed that explaining three scenarios (vs. median survival) would make sense (93 vs. 75 %), be helpful (93 vs. 69 %), convey hope (68 vs. 44 %), and reassure (60 vs. 40 %), while fewer respondents agreed that explaining three scenarios (vs. median survival) would upset people (24 vs. 36 %); all p values < 0.001. Most respondents agreed that each scenario should be presented: best case 89 %, worst case 82 %, and typical 92 %. For information about their own prognosis, 88 % preferred all three scenarios and 5 % a single estimate of the median. Respondents with higher education were more likely to agree that presenting three scenarios would be helpful (95 vs. 90 %, p = 0.05). Respondents with breast cancer were more likely to agree that explaining three scenarios would upset people (31 vs. 13 %, p < 0.001).

Conclusions

Most respondents judged presentation of best case, worst case, and typical scenarios preferable and more helpful and reassuring than presentation of just the median survival time when explaining life expectancy to patients with advanced cancer.

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Acknowledgments

We thank the patients who completed the survey, the staff and members of Breast Cancer Network Australia as well as Gary Ashton-Jones, Sally Crossing, and Remy Sage for their contribution to this study.

Funding

This work was supported by PhD scholarship funding from the National Breast Cancer Foundation (to BK), the Cancer Institute NSW (to BK), and a program grant from the National Health and Medical Research Council of Australia.

Conflict of interest

The authors have declared no conflicts of interest.

Author information

Authors and Affiliations

  1. NHMRC Clinical Trials Centre, University of Sydney, Locked Bag 77, Camperdown, Sydney, NSW 1450, Australia

    B. E. Kiely & M. R. Stockler

  2. Sydney Medical School, The University of Sydney, Edward Ford Building A27, Sydney, NSW 2006, Australia

    G. McCaughan, P. J. Beale, P. Grimison, J. Trotman, M. H. N. Tattersall & M. R. Stockler

  3. School of Medical Sciences, University of Sydney, Anderson Stuart Building F13, Eastern Avenue, Sydney, NSW 2006, Australia

    S. Christodoulou

  4. Department of Medical Oncology, Sydney Cancer Centre, Gloucester House, Missenden Road, Camperdown, Sydney, NSW 2050, Australia

    P. J. Beale, P. Grimison, M. H. N. Tattersall & M. R. Stockler

  5. Departments of Medical Oncology and Haematology, Concord Repatriation General Hospital, Hospital Rd, Concord, Sydney, NSW 2139, Australia

    P. J. Beale, J. Trotman & M. R. Stockler

Authors
  1. B. E. Kiely
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  2. G. McCaughan
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  3. S. Christodoulou
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  4. P. J. Beale
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  5. P. Grimison
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  6. J. Trotman
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  7. M. H. N. Tattersall
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  8. M. R. Stockler
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Corresponding author

Correspondence to B. E. Kiely.

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Kiely, B.E., McCaughan, G., Christodoulou, S. et al. Using scenarios to explain life expectancy in advanced cancer: attitudes of people with a cancer experience. Support Care Cancer 21, 369–376 (2013). https://doi.org/10.1007/s00520-012-1526-4

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  • DOI: https://doi.org/10.1007/s00520-012-1526-4

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