Are You Sure That's What the Doctor Said About Your Leukemia?
THURSDAY, Nov. 2, 2017 -- The stress of a frightening leukemia diagnosis may impede clear doctor-patient communication, a new study suggests.
Patients undergoing chemotherapy treatment for acute myeloid leukemia (AML) tend to view their illness and prognosis through a different lens from their doctors, researchers say.
Investigators found that patients are inclined to overestimate their risk of dying due to treatment and, at the same time, overestimate their chances for a full cure.
"Patients with AML face very challenging treatment decisions that are often placed upon them within days after being diagnosed," said senior study author Dr. Areej El- Jawahri.
"Because they face a grave decision, they need to understand what the risks of treatment are versus the possibility of a cure," said El-Jawahri, an assistant professor of medicine at Massachusetts General Hospital in Boston.
Adult AML is a type of cancer generally seen in older people in which the bone marrow makes abnormal white blood cells, red blood cells or platelets. Chemotherapy, radiation, drug therapy or a stem cell transplant can be used as treatment, according to the Cleveland Clinic.
Investigators focused on 100 AML patients. Half were in intensive care for four to six weeks, while the other half were mostly treated as outpatients. On average, patients were 71 years old.
Roughly three days after starting treatment, the patients and their doctors completed surveys.
More than 6 out of 10 patients said it was "somewhat likely" they would die because of treatment, and almost 30 percent said it was "extremely likely" they would die. However, 8 in 10 of the cancer doctors said that scenario was very unlikely.
Another survey one month later revealed other misunderstandings. While 90 percent of patients believed it was either somewhat or very likely they would ultimately be cured, three-quarters of the doctors thought it was somewhat or very unlikely that a cure was in the offing.
The gap was especially wide between doctors and outpatients. Researchers found 44 percent of outpatients thought they were very likely to achieve a cure, but none of the doctors shared that view.
The five-year survival rate for people with AML is approximately 27 percent, according to the American Cancer Society.
The findings were recently presented at a meeting of the American Society of Clinical Oncology and other groups, in San Diego.
"There were several very important factors we were not able to capture in our study, including what was actually discussed between patients and their oncologists, and whether patients simply misunderstood or misheard the information conveyed to them," El-Jawahri said in a meeting news release.
Still, the urgency of decision-making required with AML may contribute to differences in perception, the researchers said. Previous work with patients treated for other types of cancer didn't uncover such pronounced distortions.
Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.
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Posted: November 2017