Psychological factors and preferences for communicating prognosis in esophageal cancer patients

Objective: Discussing prognosis is often confronting and complex for cancer patients. This study investigates how patients' psychological characteristics relate to their preferences concerning the disclosure of prognosis. Methods: One hundred and seventy-six esophageal cancer patients participated in the study. They had undergone esophagectomy within the past 28 months and did not have evidence of cancer recurrence. Patients completed a questionnaire eliciting their preferences for prognostic information. Sociodemographic characteristics, involvement preferences, anxiety, depression, fear of recurrence, striving for quality of life (QOL) or quantity of life and trust in physicians were explored as predictors for (a) wanting to be informed about prognosis and (b) the initiation of discussion about prognosis. Results: Patients wanting all prognostic information had more fear for the disease to recur ( p<0.05) and were inclined to be more actively involved during consultation ( p<0.001). Post hoc analyses showed that patients with worse QOL scores reported more fear of recurrence. Anxiety, depression, trust and tendency to strive for QOL or quantity of life were not related to preferences concerning prognostic information. Conclusions: The more fear patients have for esophageal cancer to recur, the more information they want about prognosis. Thus, patient's fear for recurrent disease is not a reason for withholding prognostic information. Results also suggest that there is no harm in asking patients what information they want. Copyright

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