Qol-29. illness understanding and religiousness in patients with recurrent glioblastoma

Abstract BACKGROUND Glioblastoma (GBM) is an aggressive neurologic malignancy with invariably poor prognosis. However, there is evidence that patients with GBM often have unrealistic perceptions of their prognosis. Strong religious beliefs have been shown to be associated with limited illness understanding (IU) in patients with advanced cancer, but IU and religiousness have not been investigated in patients with GBM. METHODS Patients enrolled in a prospective multi-center study of recurrent GBM (Coping with Glioblastoma; NCT02375841) completed surveys after a clinical encounter with their oncologist revealing GBM progression. Psychometrically validated measures assessed parameters of IU and religiousness. IU was compared between participants with at least a moderate or high degree of religiousness (vs. not) using Fishers-exact test. RESULTS Twenty-four adult patients (median age 57) completed surveys. Fifteen (63%) identified their illness as terminal. Six patients (25%) correctly identified their life expectancy (months), eight patients predicted life expectancy of years (33%) and ten (42%) did not know or answer. Eleven (46%) reported being moderately or very religious, while nine (38%) were slightly or not at all religious. There was significantly less frequent awareness of terminal illness amongst patients identifying as religious, spiritual, or as feeling God’s presence (all p < 0.05). There was significantly less frequent IU amongst patients identifying as spiritual or believing in miracles (both p < 0.05). CONCLUSION IU is infrequent in recurrent GBM and is significantly less frequent in patients endorsing religiousness and spirituality. Strategies to improve IU, broadly and in alignment with religious and spiritual beliefs, are warranted.