Investigating Relationship Between QOL, Perception of Cure in Metastatic Disease

In metastatic renal cell carcinoma (mRCC) and metastatic bladder cancer (mBC), palliative care focuses on life extension and quality rather than a cure. A study led by Hatice Bolek, MD, aimed to investigate patients’ perceptions of treatment outcomes in mRCC and mBC and how quality of life (QOL) and optimism influence these perceptions.

A multicenter, cross-sectional online survey of 169 patients was conducted from March 15, 2023, to January 15, 2024. The primary objective measures included patients’ perceptions of their disease’s curability and expected outcomes from treatment. Ninety-one patients (53.8%) had mRCC, and 78 (46.2%) had mBC.

The online survey included structured questions with Likert scale responses to assess perceptions of overall health status, disease cure, symptom improvement, daily activity performance, and life extension due to treatment. The European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 version 3.0 was used to measure QOL, and the life orientation test was used to gauge optimism levels.

For self-assessment of general health status, 122 patients (72.2%) rated it as good, 23 (13.6%) as excellent, 20 (11.8%) as fair, and four (2.4%) as poor. Patients who rated their overall health status as good or excellent had a higher median general QOL score than those who rated it as fair or poor (83.3 [min-max, 8.3-100] vs 50 [min-max, 0-100]; P<.001).

Regarding the perception of a cure, 40.2% of patients considered it very likely, 45% considered it likely, 4.7% considered it a little likely, and only one patient reported that cure is not possible. Most participants (89.9%) reported that their cancer treatment was at least a little likely to provide symptom relief, whereas only 1.2% of participants reported that their cancer treatment did not provide symptom relief; 11.2% did not know.

“The majority of patients with mRCC and mRC help inaccurate beliefs about treatment outcomes. Better QoL and optimism were associated with increased inaccuracy,” the researchers concluded.