Are You Sure That's What the Doctor Said About Your Leukemia?

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THURSDAY, Nov. 2, 2017 (HealthDay News) -- The stress of a frightening leukemia diagnosis may impede clear doctor-patient communication, a new study suggests.

Patients undergoing chemotherapy treatment for acute myeloid leukemia (AML) tend to view their illness and prognosis through a different lens from their doctors, researchers say.

Investigators found that patients are inclined to overestimate their risk of dying due to treatment and, at the same time, overestimate their chances for a full cure.

"Patients with AML face very challenging treatment decisions that are often placed upon them within days after being diagnosed," said senior study author Dr. Areej El- Jawahri.

"Because they face a grave decision, they need to understand what the risks of treatment are versus the possibility of a cure," said El-Jawahri, an assistant professor of medicine at Massachusetts General Hospital in Boston.

Adult AML is a type of cancer generally seen in older people in which the bone marrow makes abnormal white blood cells, red blood cells or platelets. Chemotherapy, radiation, drug therapy or a stem cell transplant can be used as treatment, according to the Cleveland Clinic.

Investigators focused on 100 AML patients. Half were in intensive care for four to six weeks, while the other half were mostly treated as outpatients. On average, patients were 71 years old.

Roughly three days after starting treatment, the patients and their doctors completed surveys.

More than 6 out of 10 patients said it was "somewhat likely" they would die because of treatment, and almost 30 percent said it was "extremely likely" they would die. However, 8 in 10 of the cancer doctors said that scenario was very unlikely.

Another survey one month later revealed other misunderstandings. While 90 percent of patients believed it was either somewhat or very likely they would ultimately be cured, three-quarters of the doctors thought it was somewhat or very unlikely that a cure was in the offing.

The gap was especially wide between doctors and outpatients. Researchers found 44 percent of outpatients thought they were very likely achieve a cure, but none of the doctors shared that view.

The five-year survival rate for people with AML is approximately 27 percent, according to the American Cancer Society.

The findings were recently presented at a meeting of the American Society of Clinical Oncology and other groups, in San Diego.

"There were several very important factors we were not able to capture in our study, including what was actually discussed between patients and their oncologists, and whether patients simply misunderstood or misheard the information conveyed to them," El-Jawahri said in a meeting news release.

Still, the urgency of decision-making required with AML may contribute to differences in perception, the researchers said. Previous work with patients treated for other types of cancer didn't uncover such pronounced distortions.

Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.

More information

There's more on other cancer perceptions at PACE.

SOURCE: American Society of Clinical Oncology, news release, Oct. 23, 2017

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1 Comment

Thu Nov 09, 2017 03:03 PM

Atend of JUNE 2015,  after 2yrs of attending outpatients at Kettering general Hospital NorthantsUK for occasional platelet transfusions for MDS and tablets 1gm Tran Exanic acid 3xdaily, I was told I had CMML.   " more years havepast and after one week of patient specific platelets and occasionally a blood transfusion My platelets drop to 2 unit when normal parameters qare 150 - 450    Monocytes are about 3.0 when paramteres are zero to 1.0 My WBcount is however normal.

I thus attend  at least once a week and the haematologist weems content to monitor my condition and has assured me not to worry that my platelet count is virtially zero.   "Only when your monocyte reading goes above 10 and your bone marrow blasts also exceed 10 sould we be concerned"

Is this true?   I have not had a bone marrow apirate for about 6 months despite my very low platelet countat all times and a Haemoglobin reading of about 90 when lowest parameter is 130

 Clearly occasional transfusions  of blood (I am a B+) and regular platelet top ups are deemed more appropriate for me at the age of 83 ( I have always been able to look after a disabled wife (TIA's at 40 yrs of age and a stroke last July (2016),  but need to know whether she will have me around for more than a couple of years.   What should my reaction be if he gives me the news my CMML is now AML????   that meeting in June of 2015 came as a bit of a shock   I had just had a platetlet new low of 20  and a haemoglobin reading of 111  and my web site search made worrying reading then.   Yet here I am;   with near zero platelets and >70 HB reading and Monocites at almost 4 - and I stiil feel fit enough to keep my garden immaculate and plan outings for my wife.....  What should I make of being told "you are now AML" ....  suck on a tran examic acid tablet or find a new haematologist?   Or employ a gardener pronto and employ a carer for my wife and buy a rocking chair for me to watch them both at work from   my back patio?   .

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