Awareness of disease extent and perceived palliative treatment goals among oncology patients: a multicenter study

Abstract

Abstract In Egypt, approximately 134,000 new cancer cases and over 30,000 deaths are recorded annually. Unfortunately, a considerable proportion of patients present with an advanced stage. This patient population often faces a misconception that if they understand their disease stage and treatment goals, it will increase their anxiety. This study assessed Egyptian patients’ perceptions of their treatment objectives and the factors influencing their understanding. A survey-based study was conducted involving 487 Stage IV solid malignancy patients receiving palliative care at four Egyptian cancer centers. The survey assessed the patients’ awareness of their cancer diagnosis, stage, and treatment goals. Demographic data were collected. Responses were compared with medical records, and a total knowledge score (TKS) was calculated. A cutoff of ≥ 75% was set for satisfactory knowledge. Of the 487 patients, 46 (9.4%) denied having cancer and were excluded. Among the remaining 441 patients, despite 85.5% accurately knowing their tumor site, only 20.4% defined their exact tumor stage, and only 12% understood that the treatment was palliative rather than curative, while 28.9% thought that their tumors were benign. Collectively, 12% demonstrated a satisfactory knowledge level. The most significant factor that correlated positively with TKS was the education level (r s = 0.311, P  < 0.001). Illiterate/primary-level education patients were 2.28 times more likely to have misconceptions. A substantial percentage of cancer patients demonstrated insufficient knowledge about their disease nature and treatment goals, especially those with lower education levels. These findings highlight the importance of improving patient education and physician-patient communication to help improve the process of shared decision-making.