Purpose
To explore medical oncologists’ perceptions of cure in metastatic cancer, and how they communicate this to patients.
Sample and Setting
Medical oncologists and trainees.
Procedures
Respondents were invited via national mailing lists and social media to complete a 21-item questionnaire on perspectives of cure in solid tumours. Descriptive analyses were performed.
Results
Between Sep-Oct 2024, 127 respondents completed the survey. Median age was 39 years (range 27–75). Most worked in Australian (64%), metropolitan (88%) public practices (56%). Years since qualification:<5 (36%), 5-10 (24%), >10 (34%). Most frequently treated cancers were breast (55%), lung (52%), and colorectal (50%). 82% reported thinking patients with metastatic cancer can be cured. Metastatic cancer types with highest perceived likelihood of cure were testicular (81%), melanoma (32%), and colorectal (16%). At diagnosis of metastatic cancer, 51% reported they would tell a patient cure was possible. After treatment, 29% reported telling some patients they had been cured, and 74% telling some patients they may have been cured. A greater proportion thought cure was a realistic possibility when discussing immunotherapy (83%) rather than chemotherapy (40%), though fewer would tell patients this (44% and 27%, respectively). When asked if they discussed the possibility of cure differently by treatment type, 46% reported discussing it more frequently with immunotherapy, 5% with chemotherapy, 7% equally with both, and 42% did not discuss cure with either. When asked about discussing stopping treatment when cancer had not progressed, most would discuss it after >2 years of treatment for kidney (64%) and melanoma (63%), but were less likely to do so for breast (12%) or lung (5%). Many reported they would never discuss stopping treatment for metastatic cancers of the breast (44%) or lung (69%).
Conclusion
Most respondents believed metastatic cancer is curable, but were reluctant to tell patients they had been cured.