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Patients with advanced lung and colorectal cancer often mistakenly believe that chemotherapy can cure their disease, researchers at the Dana-Farber Cancer Institute in Boston learned in a recent nationwide study. They found that 69% of patients with advanced lung cancer and 81% of those with advanced colorectal cancer did not understand that the chemotherapy they were receiving was not at all likely to cure their disease.1 Although chemotherapy can alleviate pain and extend life in these patients by weeks or months, it very rarely can cure these cancers, researchers say.

The results were obtained from the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS), a large, nationwide study conducted by the NCI. Researchers surveyed 1274 patients at hospitals, clinics, and treatment centers across the country and comprehensively reviewed their records. Patients had been diagnosed with metastatic lung or colorectal cancer at least 4 months prior and had undergone chemotherapy.

To the authors' knowledge, this study was the first to involve such a large and varied population and demonstrated inaccurate expectations about the role of chemotherapy among patients in a variety of health care settings. The authors were surprised to find that patients who rated their communication with their physician highly were most likely to be overly optimistic about chemotherapy's ability to cure.

Lead author Jane Weeks, MD, MSc, who is the CanCORS scientific chair and the director of Dana-Farber's McGraw/ Patterson Center for Population Sciences, notes that patients' misunderstandings may create obstacles to optimal end-of-life planning. Coauthor Deborah Schrag, MD, MPH, adds that skilled clinicians should be able to set realistic expectations without causing their patients to lose hope or trust. Both add that more research is needed to determine how best to assist patients in making good decisions about their care.

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