Curability of metastatic cancer: a survey of medical oncologists.

BACKGROUND

Patients with metastatic cancer are living longer due to treatment advances. We explored oncologists' perceptions about curability in metastatic cancer.

METHODS

We invited medical oncologists to complete a 21-item online survey. We conducted descriptive analyses and thematically analyzed free-text responses.

RESULTS

A total of 126 respondents completed the survey. The median age was 39 years (range = 27-75). Most respondents worked in Australian (64%), metropolitan (88%), public practices (56%). The most frequently treated cancer types were breast (55%), lung (52%), and colorectal (50%). In total, 82% reported thinking that patients with metastatic cancer can be cured. Cancer types with the highest perceived chance of cure (median percentage) were testicular (81%), melanoma (32%), and colorectal (16%). At the time of diagnosis of metastatic cancer, 51% reported they would tell a patient that cure was possible. After treatment, 29% reported telling some patients they had been cured, whereas 74% reported telling some patients that they may have been cured. A higher proportion thought cure was a realistic possibility with immunotherapy (83%) rather than chemotherapy (40%), but only 44% and 27%, respectively, reported they would tell this to patients. In total, 46% reported discussing the possibility of cure more frequently with immunotherapy, 5% more frequently with chemotherapy, 7% as frequently with both, and 42% not discussing with either. Respondents identified oligometastatic disease, actionable mutations, and durable responses to immunotherapy as factors associated with cure.

CONCLUSIONS

Most respondents reported thinking that metastatic cancer is curable but were reluctant to tell individual patients with metastatic cancer they had been cured.