Author of

• 18975

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  P3.01 - Advanced NSCLC (ID 621)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Advanced NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/18/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 24655

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    P3.01-088j - The Transitions of Prognostic Understanding and Its Associated Factors in Japanese Patients with Advanced Lung Cancer and Their Caregivers (ID 9483)

    09:30 - 09:30  |  Author(s): S. Nukaga
    • Abstract

    Background:
    Accurate illness understanding is important for the delivery of effective care in patients with advanced cancers. However, substantial proportions of them and their caregivers are prone to mistakenly understand their prognoses and the goals of therapy. The aims of this study were to explore prognostic understanding at diagnosis in both patients with advanced lung cancer and their caregivers and to investigate how their understandings change with the laps of time after diagnosis.
    
    Method:
    A total of 245 patients with newly diagnosed advanced lung cancer (clinical stage IIIB or IV) and their 208 caregivers were recruited at Keio University and its 16 affiliated hospitals (the Keio Lung Oncology Group) in Japan between December 2013 and March 2016. We assessed their perceptions of prognosis and goals of therapy, and examined associations with their clinical status, sociodemographic characteristics, mood symptom, status of insurance, and self-reported quality of life (QOL), as well as the status of disclosure of information by their treating physicians. Participants were asked to complete the questionnaires at diagnosis and at multiple time points after diagnosis.
    
    Result:
    At the time of diagnosis, 21.7% of patients and 17.8% of caregivers mistakenly believed that the patients’ cancer was “completely curable.” Levels of depression in both patients and caregivers were significantly higher compared with those who had accurate perception of prognosis. After 3 and 6 months from the diagnosis, 18.4% and 20.0% of patients, and 17.2% and 13.4% of caregivers still believed completely curable cancer, respectively. Patients with sustained misunderstanding at 3 months after diagnosis showed significantly high functional well-being score (p =0.0077), indicating they believe they are still physically, socially, and emotionally in good condition. Of the patients and caregivers with prognostic misunderstanding at diagnosis, there were 12 patients and 11 caregivers who turned to recognize accurate perception of prognosis in 3 months later. These patients showed significantly low functional well-being score compared with those who had sustained prognostic misunderstanding(p=0.002), whereas they did not show any significant difference in performance status and the efficacy of treatment. In caregivers, there was no factor associated with accurate perception. Patients with accurate perception at 6 months after diagnosis significantly showed low physical well-being score (p=0.041).
    
    Conclusion:
    Over 15% of patients and caregivers misunderstood their prognosis. Accurate prognostic understanding at diagnosis was associated with poorer psychological status. These misunderstanding are sustained even after 6 months of diagnosis, unless their physical, social, and emotional conditions changed.