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To the Editor: Patients with metastatic cancer have been found to overestimate their survival, which may lead them to choose aggressive therapy rather than palliative care.^1-2 This has been attributed to unrealistic expectations created by physicians³ and poor patient-physician communication.⁴ Many patients also enter hospice care very late in the course of their illness, and such late referrals generally reflect decisions made by physicians and not by patients.⁵ To determine how patients with advanced cancer make choices about palliative care, we surveyed patients whose oncologists had recently recommended palliative care.

Methods

From December 1998 through June 1999, we surveyed a consecutive series of 221 patients with advanced cancer 7 to 10 days after they received a recommendation for palliative care only, without further interventional treatment. This recommendation had been presented to them by 1 of a group of 15 community-based oncologists in a southeastern US city who participated in this study. . . . [Full Text of this Article]

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