Knowledge of End-of-life Wishes by Physicians and Caregivers in Cancer Patients

Objectives: To describe communication regarding cancer patient’s end-of-life (EoL) wishes by physicians and caregivers. Methods: : An online questionnaire and telephone-based surveys were performed with physicians and caregivers respectively in three teaching hospitals in Colombia who had been involved in the EoL care of cancer patients. Results: : For 138 deceased patients we obtained responses from physicians and caregivers. In 32% physicians reported they spoke to the caregiver and in 17% with the patient regarding EoL decisions. In most cases with absence of a conversation, physicians indicated the treatment option was “clearly the best for the patient” or that it was “not necessary to discuss treatment with the patient”.Twenty-six percent of the caregivers indicated that someone from the medical team spoke with the patient about treatment, and in 67% who had a conversation, caregivers felt that the provided information was unclear or incomplete. Physicians and caregivers were unaware if the patient had any advance care directive (ACD) in 65% and 51% of cases, respectively, with a very low absolute agreement (34%). Conclusion: There is a lack of open conversations regarding EoL in patients with advanced cancer with their physicians and caregivers in Colombia. Communication strategies are urgently needed.