Abstract
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.