We overestimate how much medicine can do

"The most surprising finding in this study, though, might come from when the researchers looked at what the patients’ thought of their doctors. The survey asked about how good their oncologists were at communicating about treatment.

"Patients who rated their doctors as the very best communicators, the most open and honest, were the most likely to have the unrealistic, inaccurate expectations.

“This suggests that patients perceive physicians as better communicators when they convey a more optimistic view of chemotherapy,” the authors conclude.

As one comment stated:

The article says that
- these are all "late-stage cancer patients"
- they have all been asked the question "How likely do you think it is that this chemo therapy will cure you?"
- the correct answer to the question is "Not at All Likely"
- most of these 1000 patients chose an answer that was more optimistic than that

However, we can't assume that ALL late stage cancer patients have unrealistic expectations, but rather only the majority of the 1000 patients that actually chose to have chemo therapy.

For instance, If there were 99000 late stage cancer patients who chose NOT to have chemo therapy because it was unlikely to succeed, then the percentage of unrealistic patients is much lower.

It is not surprising to me that those patients who made an against-all-odds choice to have chemo are exactly the ones who are going to have unrealistic expectations.

"Medical research says that, in these extremely challenging cases, chemotherapy can extend life by weeks or months but it is very unlikely to provide a cure."

Rich and I both heard the same thing. On the third try Rich found a doctor that was by nature an optimist. It worked for Rich to be able to feel safe communicating his own outlook about the diagnosis. In the end the cancer gets you if you believe, don't believe, or have a positive outlook. Rich was positive. SO was I. Rich refused Chemo because he was 'more afraid of it than the cancer'. Rich got on board when he asked the doctor what would he do if he was in Rich's shoes. My question was more blunt. Do the advantages out weight the disadvantages? Rich and I heard differently.

Rich died the day before his 1st scheduled chemo. The medical team believed he was in good enough shape and would derive benefit from chemo. I think the culture of the department requires optimism.