Background: Access to palliative care services is essential for attaining universal health coverage for patients with a terminal cancer. Despite this, many patients with advanced cancer in lowincome countries, such as Myanmar, suffer at the end of life (EOL) due to little or no access to palliative care. However, actual evidence on EOL experiences of cancer patients in Myanmar is lacking. This paper aims to describe various dimensions of EOL experiences among patients with an advanced cancer from the largest public hospital in Myanmar. Methods: We surveyed 195 patients with stage IV cancer seeking care from outpatient oncology clinics to assess their quality of life, pain severity, pain medications taken, quality of communication with doctors, nursing care and health care coordination, and desire to end life sooner. We assessed socioeconomic status (SES) differences in each patient outcome using separate multivariate linear/logistic regressions. Results: Forty-one percent of the patients in our sample reported that they wish their life would end sooner. Low SES cancer patients had significantly worse quality of life, reported poor health care coordination and were more likely to report severe pain compared to high SES cancer patients visiting the same hospital. Conclusion: To improve quality of life and pain management and to reduce EOL distress among patients with advanced cancer, there is a pressing need to develop and invest in hospital and community-level palliative care services in Myanmar.

Aim To investigate prognostic awareness, preference for prognostic information, and perceived and preferred roles in decision making among patients with advanced cancer in Myanmar. Methods A cross‐sectional survey was administered at the Yangon General Hospital to stage 4 cancer patients who were at least 21 years old and aware of their cancer diagnosis. Patients were asked questions about their prognosis, participation in treatment decisions, sociodemographic and clinical information. Data from 131 patients were analyzed using descriptive statistics and logistic regressions. Results Only 15% of patients surveyed were aware that their cancer was advanced and only a quarter (26%) of patients knew that treatment intent was noncurative. The likelihood of treatment‐intent awareness was higher among patients who were male, high income, and aware that they had advanced cancer. Roughly 60% of patients reported playing an active or collaborative role in treatment decisions, with a strong preference (59%) for the latter. For the majority of patients (69%), perceived and preferred roles in decision making were the same. Sociodemographic characteristics did not predict perceived and preferred roles in decision making. Conclusions This is the first effort to analyze prognostic awareness and decision‐making practices among advanced cancer patients in Myanmar. Patients had inadequate knowledge on their disease progression and intent of treatment. Yet, the majority of them were keen to be involved in treatment decisions.

PURPOSE The aim of this study was to investigate prognostic awareness, preference for prognostic information, and perceived and preferred roles in decision making among patients with advanced cancer in Myanmar. METHODS A cross-sectional survey was administered at Yangon General Hospital to patients with stage 4 cancer who were at least 21 years old and aware of their cancer diagnosis. Patients were asked questions about their prognosis, treatment decisions, and sociodemographic and clinical information. Data from 131 patients were analyzed using descriptive and comparative statistics. RESULTS Only 15% of patients surveyed were aware that their cancer was advanced, and only 26% knew that it was terminal. One third of patients (34%) had prognostic awareness, defined as the knowledge that treatment intent is noncurative. The likelihood of awareness was higher among patients who were male, high income, and aware that they had advanced cancer. Approximately 60% of patients reported playing an active or collaborative role in treatment decisions, with a strong preference (59%) for the latter. For the majority of patients (69%), perceived and preferred roles in decision making were the same. Sociodemographic characteristics did not predict perceived and preferred roles in decision making. CONCLUSION To our knowledge, this is the first effort to analyze prognostic awareness and decision-making practices among patients with advanced stage cancer in Myanmar. Patients had inadequate knowledge of their disease progression and intent of treatment. Yet, a majority of them were keen to be involved in treatment decisions. Thus, physicians should effectively communicate prognosis and treatment intent, encouraging patients to participate in decisions whenever possible.