What do advanced cancer patients know of their disease?: A report from Italy
Abstract
The aim of this work was to investigate the awareness of diagnosis, prognosis and meaning of palliative treatment in Italian patients with advanced, incurable cancers. A group of 100 patients, referred to a Medical Oncology facility, were interviewed. Only 38 patients were aware of the malignant neoplastic nature of their disease. The remaining patients believed they had a benign neoplasia, non-neoplastic disease, or were unable to define their illness. No patient had a correct idea of the poor prognosis of the disease. Only 11.5% of 87 patients receiving chemotherapy had a correct perception of the palliative intent of the treatment, while most believed that the chemotherapy was "preventive". Dissatisfaction with the information received was expressed by a minority of patients. The awareness of diagnosis was better among women and patients with a higher educational background. Withholding the truth from cancer patients still seems very common in Italy.
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Patients with advanced cancer commonly misunderstand their prognosis, and such misunderstandings are linked to more futile treatment.
“Misunderstandings about prognosis are common16, 17, 18 and are associated with increased exposure to futile treatments.19, 20, 21, 22”
From 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) (2020) · cites this paper as [22]
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“Misunderstandings about prognosis are common(16-18) and are associated with increased exposure to futile treatments.(19-22) Most patients want considerably more information than many healthcare professionals expect, but the type and amount of information sought should be clarified.”
BackgroundRelationship between cancer patients' predictions of prognosis and their treatment preferences
Weeks, J. C. (1998) · JAMA · doi:10.1001/jama.279.21.1709 · Cited by 1,319 · see citing works
Patients’ expectations about effects of chemotherapy for advanced cancer
Weeks, J. C., Catalano, P. J., Cronin, A., Finkelman, M. D., Mack, J. W., Keating, N. L., & Schrag, D. (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1204410 · Cited by 1,149 · see citing works
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Applebaum, A. J., Kolva, E. A., Kulikowski, J. R., Jacobs, J. D., DeRosa, A., Lichtenthal, W. G., Olden, M. E., Rosenfeld, B., & Breitbart, W. (2014) · Journal of Health Psychology · doi:10.1177/1359105313484782 · Cited by 145 · see citing works
Cross-cultural differences in information disclosure evaluated through the EORTC questionnaires
Arraras, J. I., Greimel, E., Chie, W., Sezer, O., Bergenmar, M., Costantini, A., Young, T., Vlasic, K. K., Velikova, G., & on behalf of the European Organisation for Research and Treatment of Cancer Quality of Life Group (2013) · Psycho-Oncology · doi:10.1002/pon.2088 · Cited by 34 · see citing works
- Authors
- Pronzato, P., Bertelli, G., Losardo, P., & Landucci, M.
- Venue
- Supportive Care in Cancer
- Published
- 1994-07
- Volume
- 2
- Issue
- 4
- Pages
- 242-244
- ISSN
- 0941-4355 (ISSN-L)
- 1433-7339
- OpenAlex
- W2015687889
- Cited by
- 124
- References
- 0
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 2 · 2022: 1 · 2021: 4 · 2020: 4 · 2019: 2 · 2018: 4 · 2017: 5 · 2016: 5 · 2015: 5 · 2014: 5 · 2013: 8 · 2012: 3
- FWCI
- 3.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Supportive Care in Cancer (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- advanced cancer, patient knowledge of diagnosis, prognosis awareness, gender differences, educational attainment
- MeSH terms
- Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Educational Status, Female, Humans, Italy, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Neoplasms, Palliative Care, Patient Education as Topic, Physician-Patient Relations, Prognosis, Sex Factors, Truth Disclosure, Patient Satisfaction
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