24 Background: An informed decision requires good communication between the patient and their oncologist in regards to diagnosis and prognosis, especially in patients with terminal cancer. This discussion entails education about their disease, treatment options, and potential outcomes. The purpose of this study was to assess advanced-stage cancer oncology patients’ comprehension of their disease, treatment options and goals of therapy. Methods: Subjects included patients with a diagnosis of metastatic cancer with an option for palliative or life extending chemotherapy in an out-patient office at Drexel University College of Medicine. Outpatient office charts were reviewed to identify eligible patients. All subjects consented to participate. Participation included completing a 34-item questionnaire about comprehension of their cancer, satisfaction, perception of their physician interaction regarding disease education and potential barriers to patient understanding. Results: 52 patients analyzed to date: 1 patient was not aware he had cancer. 3 patients (5.7%) thought there was no longer cancer in their bodies. 33 patients (62%) thought the goal of therapy was to cure their cancer. 27 patients (51%) thought the goal of therapy was to extend how long they will live. 11 patients (20.7%) thought the goal of therapy was to palliate symptoms. 5 patients (9.4%) did not know why they were on therapy for their cancer. 5 patients (9.4%) indicated they had talked about hospice with their doctor. 5 patients (9.4%) felt they shouldn’t ask any questions. 48 patients (90.5%) felt they were participating in their treatment decisions. 4 patients (7.5%) stated they didn’t understand the medical terms used by the doctors. Compared to what patients wish they knew, almost 30% felt they knew half or very little about their diagnosis and 33% felt they knew half, very little, or nothing about their prognosis. Conclusions: Due to discrepancies between patient understanding and the intended goals of care, our study highlights the need for further guidance in effectively communicating extent of disease and predicted outcome. It is also important to periodically ask patients to discuss their understanding of their diagnosis, prognosis, and treatment options.

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