Preferences for life and functional prognostic information among Japanese patients undergoing first-time chemotherapy.

Abstract

Background: Prognostic information is paramount in the decision-making of patients with cancer. Furthermore, the type of information required depends on cancer progression. However, preferences for such information among patients undergoing cancer chemotherapy for the first time have not been well-elucidated. This study aimed to identify patient preferences for prognostic information to improve informational support provided by healthcare providers.

Methods: This study was conducted as part of a longitudinal study and analyzed data on preferences for prognostic information collected after one course of cancer chemotherapy. A questionnaire was used to assess preferences for prognostic information (life and functional prognoses), knowledge of chemotherapy, anxiety about adverse events (AEs), and information-seeking behaviors. Patient characteristics were collected, and the relationships between variables and preferences for prognostic information were analyzed.

Results: Fifty-four patients participated in the study (mean age: 66.0 years; 55.6% male). Regarding prognosis, 40.7% of patients answered "strongly agree" or "agree" on a six-point scale to the degree to which they wanted to know their life prognoses, whereas 31.5-50.0% wanted to know their functional prognosis. No significant differences were observed in the types of prognostic information; however, each prognostic variable exhibited a positive correlation (r=0.60-0.89, P<0.001). Subgroup analyses were performed according to treatment intent (adjuvant, life-sustaining/palliative). In the life-sustaining/palliative group, a statistically significant association was observed between the propensity to seek information regarding life prognosis and the execution of information-seeking behavior among participants (P=0.04), and correlation analysis revealed a positive correlation between older adult-only households and thinking (r=0.40, P=0.02) and eating prognoses (r=0.38, P=0.03). In the adjuvant group, age exhibited a negative correlation with life prognosis (r=-0.59, P=0.009).

Conclusions: In Japanese patients undergoing cancer chemotherapy for the first time, both functional and life prognoses are important. Patients who wanted to know about one type of prognosis also tended to want information about another. For patients receiving life-sustaining/palliative care, life prognosis was important, and these patients tended to seek information. Being in an older adults-only household was significantly correlated with the desire for prognostic information, particularly thinking and eating habits. We speculated that this tendency would be observed only in the life-sustaining/palliative group, as these patients were more aware of approaching the end of life. In the adjuvant group, a tendency for decreased prognostic awareness was suggested in older adults, which may reflect a change in treatment values with age, from "life extension" to "functional maintenance". Healthcare providers should offer individualized informational support that considers each patient's specific treatment purpose and background rather than a one-size-fits-all approach.